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Patient Service Representative- REHAB

Company: Cleveland Clinic
Location: Stuart
Posted on: November 14, 2021

Job Description:

I. Basic Purpose:Performs a variety of duties to facilitate patient care; answers phones, interviews patients, posts charges, handles scheduling of occupational, physical, speech therapy, acupuncture services, and audiology patients. Interviews patients to gather demographic and financial data. Is knowledgeable of compliance policies and requirements. Demonstrates the ability to multi-task through outpatient rehab's dual EMR systems and solve problems/issues. Obtains authorization from insurance companies as required. Must be flexible with hours of availability. Provides these services in a manner that consistently exceeds the expectations of the customers we serve. Maintain customer confidentiality at all times.II. Major Duties and Responsibilities:1. Complies with established corporate and departmental policies, procedures, objectives, quality assurance methods, and safety codes. Demonstrates compliance with licensing, regulatory and accrediting agency provisions as required.2. Consistently demonstrates appropriate and professional communication behavior toward patients, customers, and coworkers. Cooperates with Management and peers to promote an environment of teamwork and collaboration.3. If necessary, establishes patient medical record number to minimize the medical risk to patients. Obtains necessary signatures from patients or guardians authorizing treatment.4. Coordinates all scheduling of treatments, process registration and pre-registrations on all patients utilizing the patients' identifier options. Adjusts therapists schedules as directed by Site Manager and Administrative Manager as needed. Obtains/enters complete and accurate demographic/ financial/clinical information in an expedient manner. Ensures that insurance information is complete, provides counseling regarding payment in accordance with corporate credit and collection policies.5. Maintains a working knowledge of the insurance billing and their authorization and reimbursement policies. Obtains authorization from insurance companies as required. Knowledge of managed careprotocols and procedures involved in patient pre-authorization and re-authorization. Determines/ requests/ collects self pay balances due and/or completes appropriate financial forms when patients are unable to meet the requirements. Assists with explanation of patient's billing if requested. Completes billing corrections as directed.6. Collects and posts daily cash, checks, credit and debit payments, time of service accounts, assists in maintaining and balancing rehab cash drawer, and deposit procedures at the end of the workday. Runs reports for credit cards and daily log sheet for Financial Services.7. Responsible for accurate assembly, maintenance of patients charts. Maintain department records, reports and files as required. Copying charts as requested by attorney's offices, corporate business office, and others. Archiving patient charts as department policy requires, and requesting archived charts when requested.8. Reviews Medicare Secondary Payor (MSP) queries to determine payor for Medicare and Medicare HMO patients.9. Demonstrates outstanding customer service in all interactions with internal and external customers. Responds to patient problems, complaints and inquiries. Ensures all complaints are resolved or referred to appropriate personnel. Communicates clearly and concisely with all levels of individuals while complying with confidentiality criteria. Demonstrates ability to understand and explain department and hospital policies and procedures.10. Contacts physician offices for diagnosis, authorization, or other information if necessary. Contacts physician offices/insurance companies for benefits/authorizations and documents outcome in the system.11. Identifies process improvement opportunities and actively participates in Performance Excellence opportunities. Promotes the team concept with coworkers by addressing issues in a constructive/proactive manner.12. Attend all departmental meetings as required. Attends all Rehab in-services and educational seminars as required.13. Answers telephones, routes callers, takes messages, and provides routine information to callers according to corporate standards.14. Responsible for retrieving, reviewing and responding to all e-mail correspondence, related to Rehab and Business Office requests in a timely manner.15. Maintains confidentiality of patient information.16. Maintains annual mandatory education requirements specific to position as mandated by Martin Health System.17. Performs all other duties as assigned or requested.III. Minimum Requirements (experience, training, and education):To effectively fulfill this position, candidate must meet the following requirements:> High school graduate or equivalent; experience in a healthcare/medical office environment is preferred;> Preferred: Attend and successfully pass Health Information Management college coursesdesignated for the position;> Certified Revenue Cycle Specialist (CRCS) certification - preferredMust successfully pass pre-employment testing which may include MHS Medical Terminology, Customer Service, Medical Secretarial, and Data Entry tests. Must obtain passing (80% or better) score on Medicare Fraud & Abuse test during 6-month probationary period. Must maintain passing (80% or better) score on annual departmental Access competency assessment. Must have excellent interpersonal skills and be able to work effectively with a multidisciplinary team

Keywords: Cleveland Clinic, Palm Beach , Patient Service Representative- REHAB, Sales , Stuart, Florida

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