Patient Services Representative

Join Team Tidelands and help people live better lives through better health! Are you passionate about quality and committed to excellence? Consider joining our Tidelands Health team. As our region's largest health care provider, we are also one of our area's largest employers. More than 2,500 team members at more than 70 Tidelands Health locations bring our healing mission to life each day.

A Brief Overview

The purpose of this position is to register all patients needing services and handle all first call resolution for the departments assigned. The role is responsible for obtaining accurate and complete demographic, financial, and medical information. The employee will transfer calls as appropriate, and/or make appointments as necessary. For procedures, the employee may pre-register the patient, verifying insurance, etc. In addition, the employee may assist with making referrals. The person performing this role anticipates and acts on the needs of our customers to enhance the patient experience. Patient Services Representative III is responsible for scheduling complex and specialized procedures across multiple EMR modules/platforms (i.e., Surgery, Interventional Radiology, Recurring Services, etc.) and coordinating multiple resources for patient services. Will also perform duties for prior authorization, referrals (incoming/outgoing), good faith estimates, and/or payment collections. Fully competent at performing the common tasks and responsibilities under general supervision, this is the full level of proficiency that all employees are expected to achieve.

What You Will Do

• Engage patients throughout the registration process to create a welcoming and positive patient experience.
• Consistently display good customer service behaviours to all patients and visitors to promote positive patient experiences.
• Assist patients to their destination as needed and manage patient visitor flow according to hospital policy and safety guidelines.
• Obtain and accurately enter required information for registration into the electronic health system.
• Follow prescribed procedures for positive identification and medical record number assignment, so no duplication or wrong patient registrations occur.
• Review demographic and insurance information for completeness, and follow through with correcting any deficiencies, so collection efforts are not delayed due to insufficient or incorrect information.
• Ensure all appropriate signatures are obtained and forms completed including but not limited to the following: Medicare Secondary Payer Questionnaire, Advance Beneficiary Notice (ABN waiver), HIPAA Privacy Notice, AOB (Assignment of Benefits), Medicare Important Messages etc.
• Provide information and/or handouts and answer questions on patient rights and responsibilities, HIPAA Privacy Notice, and any financial assistance documentation.
• Thoroughly and accurately document insurance verification information in the system, identifying deductibles, copayments, coinsurance, and policy limitations.
• Obtain referral, authorization and pre-certification information if needed; document this information in the EHR, electronic health record.
• Answer all inbound and/or place outbound telephone calls as assigned and appropriately direct callers, ensuring all calls are handled efficiently and in a timely manner.
• Consistently exhibit the highest level of service to all callers and fellow staff.
• Contact patients by phone to remind them of upcoming appointments, relay instructions and/or to ask follow-up care questions as needed.
• Cancel and reschedule appointments as needed.
• May assist with identifying and initiating necessary referrals for specialist appointments, procedures and tests.
• Organise, expedite and follow-up on any paperwork related to patient care.

Education Qualifications

• High School Diploma or equivalent Required
• Associate's Degree with Medical Terminology course completion Preferred

Experience Qualifications

• At least three (3) years of related customer facing healthcare experience with at least one (1) year scheduling or preregistering patients (On the job performance and demonstration of mastery of duties will be considered) Required

Skills And Abilities

• Ability to interact successfully with the public.
• Ability to perform effectively despite sudden deadlines and changing priorities; maintaining personal composure in high stress situations required.
• Ability to demonstrate a high level of interpersonal skills required to interact with patients, patients’ families/visitors and clinical staff.
• Ability to perform with a high degree of accuracy and with meticulous attention to detail required.
• Demonstrate a strong ability to use initiative and judgment and to identify, analyse and solve problems required.

Physical Demand

Light Physical Demand

The intent of this job description is to provide a representative level of the types of duties and responsibilities that will be required of positions given this title and shall not be construed as a contract for employment nor a declaration of the total of the specific duties and responsibilities of any particular position. Employees may be directed to perform tasks other than those specifically presented in this description.

Tidelands Health is an Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, colour, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, or veteran status. Tidelands Health does not discriminate against employees or applicants for employment on the basis of race, colour, creed, religion, age, national origin, disability, marital status, veteran status, gender, genetic information, familial status, or any other legally protected status.