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Patient Services Representative
5 months ago
Responsibilities:
-Process and verify administrative and financial components of financial clearance including validation of
insurance benefits, medical necessity, routine and complex pre-certification, prior-authorization, scheduling and
pre-registration, patient benefit and cost estimates, and pre-collection of out-of-pocket cost share.
-Obtain pre-certifications, authorizations, and referrals for upcoming appointments
-Communicate recommended changes to schedules and care planning to ensure alignment with authorization
requests and payor compliance
-Liaison between patient, insurance payors and providers to obtain prior authorization for prescheduled services
-Effectively address issues and offer information and support to both patients and physicians concerning financial
clearance matters
-Process stat request prioritization
-Verify demographic information
Qualifications:
-High School Diploma or equivalent
-3+ years’ experience with patient registration in a hospital or physician office, directly with obtaining patient
demographic and financial information, handling insurance verification and obtaining authorizations
-Proficient with commercial and government insurance plans, payer networks, government resources
-Proficient with medical and insurance terminology
-Strong customer service skills, including ability to understand, interpret, evaluate, and resolve basic to complex
service issues.
-Strong attention to detail and accuracy
-Excellent verbal and written communication, telephone etiquette, interviewing, and interpersonal skills to
interact with peers, management, patients, client, and external agencies
-Ability to work with a variety of stakeholders
-Proficient in utilizing a variety of computer applications and software, including but not limited to Microsoft
Office Suite, Internet Explorer, and other relevant programs
-Proven track record in roles that involve managing multiple critical priorities, with a focus on delivering high quality results and meeting performance metrics
-Must be willing to work onsite in Ortigas, Pasig City.
