Patient Services Representative

Principal Accountabilities

Accepts referrals, verifies for completeness and appropriateness, communicating with referral sources to obtain additional information as needed. Creates and maintains patient charts. Assures that charts contain MD referral orders, past medical records, documents required for clinical use, documents for patient signature. May assist clinical diabetes staff by downloading patient meters. May compile and report units of service data to Finance for productivity reports. Obtains confidential information from patient or family member, including demographic, financial, and medical. Pre-registers patients into the patient accounting system, verifies insurance, verifies co-payment requirements and obtains/completes all necessary authorizations, certifications, notifications and government required documentation.

Prepares charge tickets for clinical services. In selected centers, audits every patient chart for chargeable services and takes corrective action to ensure they are accurate and complete. Researches and clears problems identified by patient accounting systems required to ensure complete and appropriate billing of assigned claims. May post billing charges and collection of cash/credit receipts to patient accounts. May translate narrative diagnosis into ICD-9 codes and enter into billing system.

Schedules patients for initial and follow-up appointments and maintains data in computerized scheduling program.