Main Responsibilities and Required Skills for Patient Services Representative
A Patient Services Representative (PSR) is a customer service professional who works in a healthcare setting, such as a hospital or clinic. They greet and check in patients, process insurance claims, and answer patient questions. In this blog post we describe the primary responsibilities and the most in-demand hard and soft skills for account administrators.
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Main Responsibilities of Patient Services Representative
The following list describes the typical responsibilities of a Patient Services Representative:
Address
Address billing issues and inquiries from patients.
Adhere to
Adhere to HIPAA, PCI, and Change Healthcare Policies and Procedures.
Analyze
Analyze and explain to patients outstanding claims and patient payment responsibility.
Analyze problems from the customers' point of view.
Answer
Answer all incoming calls and redirect them or keep messages.
Answer incoming calls using proper telephone etiquette.
Answer messages and type notes from EHR.
Answer or makes inbound / outbound calls in a fast-paced environment.
Answer patient inquiries via phone.
Answer patient questions and address concerns with enthusiasm and complete knowledge of all services.
Answer phones professionally and warmly to assist all callers with their healthcare objectives.
Answer telephone calls and provide accurate information to patients.
Answer telephones, and direct calls to appropriate staff.
Answer telephones, confirm appointments, and transfer calls to appropriate staff member, as needed.
Anticipate
Anticipate patients' / customers' needs and acts accordingly.
Apply
Apply learning for improved performance.
Arrange
Arrange for payment plans according to Allergy.
Arrange treatment supplies to keep them in order.
Ask
Ask questions to determine nature of problem and follow through with troubleshooting process.
Ask for assistance as needed to expedite patient concerns as quickly as possible.
Assemble
Assemble files and maintain integrity of patient charts.
Assist in
Assist consults / patients with the completion of the forms as necessary.
Assist in other front office duties at the request of the Practice Manager.
Assist in special projects and other duties as assigned.
Assist patients and families.
Assist patients with necessary paperwork as needed.
Assist patient to complete all necessary forms and documentation including medical insurance.
Assist the OM with Accounts Receivable to ensure clinic is within company target.
Assist with coordinating clinic schedules for all physicians.
Assist with maintaining provider templates and appointment schedules, as needed.
Assure
Assure 100% compliance with all aspects of Cash Handling Policy / Procedure.
Attend
Attend all appropriate meetings as assigned.
Attend all regular staff meetings.
Attend staff meetings and other gatherings, as required.
Attend to billing corrections in a timely fashion.
Change
Change linens, such as bed sheets and pillow cases.
Charge
Charge capture and over-the-counter payment posting.
Check
Check ID and Insurance card for all visits.
Check-in
Check-in and check-out all patients using the time clock within medical management system.
Check
Check insurance eligibility and scan Medicaid, Medicare and private insurance cards.
Check scheduled patients in / out and ensures proper documentation is received from patient.
Clean
Clean and organize work area and disinfect equipment after treatment.
Collaborate with
Collaborate with patient to prepare and submit applications as appropriate.
Collect
Collect co-payments and verify insurance coverage as appropriate.
Collect co-pays and outstanding balances.
Collect patients copayments, deductible and patient's balances.
Collect and apply patient payments, adjustments, and reconciles daily cash reports.
Collect and review all patient insurance information and completes insurance forms.
Collect and revise all patient insurance information.
Collect co-pays and fees as needed, including closeout of drawer at the end of the day.
Collect co-pays, co-insurance, and deductible if necessary.
Collect co-pays, deductibles and other out of pocket amounts and fees at the time of visit.
Collect patient data involving medical, demographic and insurance information.
Communicate
Communicate effectively in the English language in person, on the phone, & in writing.
Communicate effectively with clinic team members via the EHR and in-person.
Communicate patient arrival to clinical staff promptly.
Communicate to PSR Lead and / or Area Manager as needed.
Complete
Complete process for Request for Medical Records.
Comply
Comply with HIPAA and compliance guidelines.
Conduct
Conduct financial assessments for designated patients as described in the policy and procedure.
Conduct patient check-in and check-out process.
Confirm
Confirm patient information and enters changes into computer system.
Confirm patient insurance verification and eligibility.
Connect
Connect patients to insurance eligibility services, as needed.
Consult
Consult with patients regarding their benefits, coverage and financial options.
Coordinate
Coordinate consumer appointments with the Centralized Scheduling department.
Determine
Determine if any consents are out of date.
Determine uncollectible balances and refers such accounts to the Practice Manager.
Distribute
Distribute outbound correspondence or copies of records as necessary.
Document
Document all patient and device related complaints electronically.
Document all patient correspondence in electronic medical record (EMR).
Ensure
Ensure all faxes are cleared off the machine and are distributed throughout the day.
Ensure all phones are answered within 3 rings.
Ensure proper posting of charges into the practice management system daily as.
Ensure reception and lobby areas are safe, organized, and clean.
Ensure registration forms and other patient paperwork is complete and up to date.
Ensure support and solutions provided are aligned with Department and Standard Operating Procedures.
Ensure that all client / patient services rendered are entered into the data base on a daily basis.
Ensure that office is closed and locked up properly.
Ensure that payments collected are accurately entered into Epic system.
Enters
Enters referral information as appropriate.
Escalate
Escalate questions / issues to appropriate resources as needed.
Explain
Explain hospital policies, including payment and credit policies.
Facilitate
Facilitate any physician requests throughout the day.
Facilitate effective patient flow using the proper callback system.
Facilitate financial screening services.
Facilitate no-show appointments (calling patients, cancelling, rescheduling).
File
File and pull medical charts as needed.
Focus on
Focus on the delivery of patient care and facilitates the needs of the physician.
Follow
Follow all established policy and procedures related to this position.
Follow OSHA / WISHA (including usage of PPE) guidelines.
Follow up in a timely manner with status updates to customers.
Gather
Gather patient demographic and insurance information to begin the scheduling process.
Give
Give patients oral contrast as indicated by scan type and / or special instructions.
Greet
Greet and check in patients in a friendly manner.
Greet and check in patients in professional and friendly manner.
Greet patients and escort them to the exam rooms.
Greet patients and visitors in a warm and professional manner.
Handle
Handle difficult situations while maintaining quality customer service and expected.
Handle phone calls in a professional, courteous, and calm manner.
Help
Help to monitor patient waiting areas and facilitates.
Honor
Honor patient / customer / employee confidentiality.
Identify
Identify patients by date of birth and name in computer system.
Identify, research and resolve all customer requests.
Input
Input demographic information, billing information and insurance into medical management system.
Keep
Keep patient demographics and insurance information accurate and up-to-date in in the EHR.
Keep the patient reception area neat and clean at all times throughout the day.
Learn
Learn, understand and identify client / customer problems and recognize core issues.
Listen
Listen and resolve patient, provider, and any customer complaints.
Maintain
Maintain and retain a customer service attitude at all times to ensure patient satisfaction.
Maintain a positive and flexible attitude, cooperate and work collaboratively to help others.
Maintain a team supportive attendance record.
Maintain balanced cash banks for all research studies stipends and cash drawer.
Maintain certification or licensure from an approved certification agency.
Maintain charting compliance with current standards.
Maintain current knowledge of all physicians and services of the practice.
Maintain flexibility regarding scheduling changes, communicating changes to patients, and staff.
Maintain office equipment and office supplies in the front office areas.
Maintain PHI and HIPAA compliance.
Maintain strict confidentiality of personal health information (PHI).
Maintain work area and lobby in neat and orderly manner.
Make
Make outbound calls in an effort to resolve the account.
Manage
Manage multiple phone lines.
Meet
Meet and greet patients, verify insurance eligibility and demographics.
Meet department productivity standards.
Meet or exceed identified patient experience metrics.
Meet or exceed the performance measures established by the Practice Management Dept..
Monitor
Monitor patient waiting period and alert clinical staff as needed.
Monitor confirmation reports to cancel appointments and respond to comments.
Monitor waiting room and appearance at all time.
Notify
Notify clinical staff of patient arrivals.
Obtain
Obtain authorization from managed care companies to cover outpatient services.
Obtain current information from established and new.
Participate in
Participate and contribute in a team-based environment.
Participate in agency wide quality assurance and improvement as needed.
Participate in emergency preparedness plan as dictated by the policy and procedures.
Perform
Perform focused reviews of charts to determine if all financial and demographic data is current.
Perform opening and closing duties for the care center.
Perform tasks conscientiously and thoroughly while adhering to established goals and objectives.
Post
Post approved adjustments to patient accounts.
Prepare
Prepare accounts for collections and work with outside collection agencies.
Prepare accurate daily statistical and other reports as deemed necessary.
Prepare charts and accounts on a daily basis as applicable.
Prepare deposits for bank as needed.
Prepare deposit slip and delivers "daily close” packet to the Manager or.
Prepare new patient charts accurately.
Present
Present financial policies and arrangements accurately to patients.
Process
Process patient arrivals quickly and efficiently.
Process payments and update medical billing system accordingly.
Produce
Produce and monitor assigned reports.
Protect
Protect / observes patient confidentiality per policies and procedures.
Provide
Provide account status updates to the collection agencies upon request.
Provide a friendly and warm greeting to all patients and / or providers.
Provide all documentation to expedite payment.
Provide basic information about contracted insurance plans.
Provide best in class customer service by phone, email and in person.
Provide check-in services by promptly greeting patients as they arrive to the health center.
Provide education to patients about our medical and cosmetic procedures.
Provide financial counseling to patients and their families.
Provide friendly, knowledgeable and responsive internal and external customer service.
Provide itemized statements to collection agencies upon request.
Provide Practice Manager / Supervisor with feedback for coworker evaluations.
Provide vital office support that maximizes the flow of front desk operations.
Receive
Receive patients at the care center.
Reconcile
Reconcile daily collections and prepares deposits logs accordingly.
Reconcile fee slips and run reports at end of shift or throughout day.
Register
Register patient according to established protocol.
Register patients in the system as necessary.
Request
Request orders and processes new / same-day requests.
Research
Research and resolve claim delay issues.
Respond to
Respond promptly to patient, physician and clinical requests.
Respond to medical records requests as.
Respond to incoming online insurance updates and email information requests from patients.
Respond to telephone inquiries from potential patients.
Resubmit
Resubmit claims and process all insurance / patient correspondence.
Review
Review Explanation of Benefits (EOB) for consistency.
Route
Route messages to appropriate discipline.
Scan
Scan patient records into EHR.
Schedule
Schedule and confirm patient appointments.
Schedule appointments for client / patient care including all follow-up appointments.
Schedule appointments for patients.
Schedule Orders Report, recall report, follow-up report.
Schedule patient appointments for all practice providers and locations.
Schedule, reschedule and confirm new patient appointments.
Schedule, reschedule and coordinate all patient appointments and adjunct tests per office protocol.
Schedule return appointments and set up reminder notifications.
Schedule and confirm appointments.
Screen
Screen visitors and responds to routine requests for information from patients and vendors.
Seek
Seek feedback on how to improve performance and offers constructive feedback, as well.
Serve
Serve as an internal resource to assist sales representatives and internal staff when necessary.
Set
Set appropriate expectations for patient and staff like.
Set up
Set up charts for next day clinic.
Support
Support team leads when needed.
Take
Take appropriate action for medical and non-medical emergencies occurring within the office.
Triage
Triage and route clinical calls as appropriate.
Triage patient requests thoroughly when scheduling their appointment.
Troubleshoot
Troubleshoot and research questions related to patient and insurance carrier calls.
Understand
Understand the importance of branding and translating the brand into acts of service.
Utilize
Utilize EHR to communicate about appointment details.
Verify
Verify insurance coverage.
Verify insurance information.
Verify Insurance is accurate and up to date.
Verify demographic and billing information.
Work
Work cross-functionally to support organizational goals.
Work to maintain full schedules and maintain office schedule flow.
Work well as a team member and on independent projects as requested.
Work with Department Manager and Supervisor to promote efficiency within PSR activities.
Work with the Managed Care office to identify and interpret contracts governing patient care.
Most In-demand Hard Skills
The following list describes the most required technical skills of a Patient Services Representative:
Computer
Call Center
Healthcare
Most In-demand Soft Skills
The following list describes the most required soft skills of a Patient Services Representative:
Written and oral communication skills
Interpersonal skills
Organizational capacity
Bilingualism
Multi-task
Problem-solving attitude
Attention to detail
Detail-oriented
Patient scheduling
Active listener
Courteous
Time-management
Cooperative
Effectively interact with physicians, patients and other staff members
Professional maturity
