Representative - Patient Financial Services I - Memorial Healthcare System
Pembroke Pines, FL
About the Job
At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience.
Summary:
The Patient Financial Services Representative (PFSR) serves as the first point of contact in greeting patients and guarantors in the hospital, ambulatory or medical office setting. The PFSR engages with the patient or guarantor to obtain pertinent information and answer any questions in an effort to ensure that all required demographic, financial, and insurance eligibility information is gathered and verified. Ensures all required notices and consent forms are signed accordingly.
Responsibilities:
Interviews patients and guarantors at the workstation or bedside to obtain all necessary information, including a copy of the patient or guarantor identification card.May confirm physician and prescription orders ensuring accuracy.May schedule walk-in appointments for services offered.Collects patient out-of-pocket responsibility per collection guidelines. Provides patient estimates as requested. Prepares and balances a daily deposit of all payment collections.Provides exceptional customer service and ensures all questions and concerns are addressed in a timely and courteous manner. May guide the patient to appropriate destination for services.Obtains pre-certification and authorization.Verifies insurance benefits including obtaining insurance card(s) and confirms coverage is active. Determines correct insurance filing order, if multiple insurance coverages are effective for that service.Explains polices including all regulatory and financial consent forms; secures all required signatures.May perform patient discharge functions including, but not limited to, review of after visit summary (AVS), future appointment scheduling, and referrals.
Competencies:
ACCOUNTABILITY, ACCURACY & QUALITY, CUSTOMER SERVICE, EFFECTIVE COMMUNICATION, ORGANIZATION SKILLS, PATIENT AND FAMILY CENTERED CARE, PROBLEM SOLVING, PRODUCTIVITY, RESPONDING TO CHANGE, STANDARDS OF BEHAVIOR, TEAM WORK
Education and Certification Requirements:
High School Diploma or Equivalent (Required)
Additional Job Information:
Complexity of Work: Requires excellent communication skills, critical thinking skills, decisive judgment, and the ability to work with minimal supervision. Must be able to work in a stressful environment and take appropriate action. Ability to work and build relationships collaboratively. Required Work Experience: No experience required. One (1) year of related hospital, medical office, or customer service experience preferred. Other Information: In Memorial Physician Group (specialty practices), additional responsibilities include: (1) obtain specialty authorizations (2) authorization denial and peer to peer process (3) patient care navigation ex: surgical and procedural coordination and scheduling for patient specific populations (4) handle all incoming calls and physician and hospital back line (5) obtain and confirm referralsIn the Hospital, additional responsibilities include: (1) Upon validation of patient identity, place identification band on patient (2) obtain signatures for hospital specific regulatory forms not required in an ambulatory or office setting (3) obtain authorizations for walk-in appointments (4) determine when financial assistance is needed.In Memorial Primary Care, additional responsibilities include: (1) MIH-MPC program patient referral, payment collection and eligibility scheduling (2) process referral work-ques and same day access requests (3) work with Patient Access Center on real time patient requests (4) address prescription refill requests, patient advice requests through MyChart, and provider scheduling template.
Working Conditions and Physical Requirements:
Summary:
The Patient Financial Services Representative (PFSR) serves as the first point of contact in greeting patients and guarantors in the hospital, ambulatory or medical office setting. The PFSR engages with the patient or guarantor to obtain pertinent information and answer any questions in an effort to ensure that all required demographic, financial, and insurance eligibility information is gathered and verified. Ensures all required notices and consent forms are signed accordingly.
Responsibilities:
Interviews patients and guarantors at the workstation or bedside to obtain all necessary information, including a copy of the patient or guarantor identification card.May confirm physician and prescription orders ensuring accuracy.May schedule walk-in appointments for services offered.Collects patient out-of-pocket responsibility per collection guidelines. Provides patient estimates as requested. Prepares and balances a daily deposit of all payment collections.Provides exceptional customer service and ensures all questions and concerns are addressed in a timely and courteous manner. May guide the patient to appropriate destination for services.Obtains pre-certification and authorization.Verifies insurance benefits including obtaining insurance card(s) and confirms coverage is active. Determines correct insurance filing order, if multiple insurance coverages are effective for that service.Explains polices including all regulatory and financial consent forms; secures all required signatures.May perform patient discharge functions including, but not limited to, review of after visit summary (AVS), future appointment scheduling, and referrals.
Competencies:
ACCOUNTABILITY, ACCURACY & QUALITY, CUSTOMER SERVICE, EFFECTIVE COMMUNICATION, ORGANIZATION SKILLS, PATIENT AND FAMILY CENTERED CARE, PROBLEM SOLVING, PRODUCTIVITY, RESPONDING TO CHANGE, STANDARDS OF BEHAVIOR, TEAM WORK
Education and Certification Requirements:
High School Diploma or Equivalent (Required)
Additional Job Information:
Complexity of Work: Requires excellent communication skills, critical thinking skills, decisive judgment, and the ability to work with minimal supervision. Must be able to work in a stressful environment and take appropriate action. Ability to work and build relationships collaboratively. Required Work Experience: No experience required. One (1) year of related hospital, medical office, or customer service experience preferred. Other Information: In Memorial Physician Group (specialty practices), additional responsibilities include: (1) obtain specialty authorizations (2) authorization denial and peer to peer process (3) patient care navigation ex: surgical and procedural coordination and scheduling for patient specific populations (4) handle all incoming calls and physician and hospital back line (5) obtain and confirm referralsIn the Hospital, additional responsibilities include: (1) Upon validation of patient identity, place identification band on patient (2) obtain signatures for hospital specific regulatory forms not required in an ambulatory or office setting (3) obtain authorizations for walk-in appointments (4) determine when financial assistance is needed.In Memorial Primary Care, additional responsibilities include: (1) MIH-MPC program patient referral, payment collection and eligibility scheduling (2) process referral work-ques and same day access requests (3) work with Patient Access Center on real time patient requests (4) address prescription refill requests, patient advice requests through MyChart, and provider scheduling template.
Working Conditions and Physical Requirements:
- Bending and Stooping = 60%
- Climbing = 0%
- Keyboard Entry = 100%
- Kneeling = 0%
- Lifting/Carrying Patients 35 Pounds or Greater = 60%
- Lifting or Carrying 0 - 25 lbs Non-Patient = 80%
- Lifting or Carrying 2501 lbs - 75 lbs Non-Patient = 40%
- Lifting or Carrying > 75 lbs Non-Patient = 0%
- Pushing or Pulling 0 - 25 lbs Non-Patient = 80%
- Pushing or Pulling 26 - 75 lbs Non-Patient = 80%
- Pushing or Pulling > 75 lbs Non-Patient = 0%
- Reaching = 80%
- Repetitive Movement Foot/Leg = 0%
- Repetitive Movement Hand/Arm = 80%
- Running = 0%
- Sitting = 80%
- Squatting = 80%
- Standing = 80%
- Walking = 80%
- Audible Speech = 80%
- Hearing Acuity = 80%
- Smelling Acuity = 0%
- Taste Discrimination =
Source : Memorial Healthcare System