Patient Service Specialist PR

Position Summary
The Patient Service Specialist Patient Relations (PR) ensures the Mission/Vision and financial integrity of Health First, Inc. by achieving sustainable levels of internal and external customer service, regulatory compliance, and financial performance within the revenue cycle.

Primary Accountabilities

Prepare charts for scheduled patients, obtain and verify authorizations, perform medical necessity, and ensure accurate orders are in place for all service lines.

Register patients by using two patient identifiers (name, date of birth, etc.), confirm armband accuracy, input demographics information, and secure the required forms to meet compliance with regulatory policies.

Perform Medicare compliance review on all applicable Medicare accounts to determine coverage, identify patients who may need Medicare Advance Beneficiary Notices of Noncoverage (ABNs), and issue ABN forms as needed.

Complete Medicare Secondary Payer Questionnaire (MSPQ) for Medicare beneficiaries.

Verify insurance eligibility and benefits through eligibility systems or by contacting insurance companies via phone, fax, online portal, and other resources to determine extent of coverage within established timeframe before scheduled appointments and during or after care for unscheduled or emergent patients.

Calculate patients’ co‑pays, deductibles, and co‑insurance; provide patients with personalized estimates of their financial responsibility based on their insurance coverage prior to service for both emergency and outpatient services.

Attempt to collect patient cost‑sharing amounts (e.g., co‑pays, deductibles) and outstanding balances prior to service and post‑payments.

Ensure compliance with state and federal laws regarding all aspects of role.

Operate proficiently in all registration environments.

Mentor staff and assist with training new staff on department specific procedures and applications.

Reconcile payment collections daily, prepare bank deposits, and distribute petty cash.

Minimum Qualifications

Education: High School diploma or equivalent.

Work Experience: 1 year customer service experience.

Knowledge/Skills/Abilities: Working knowledge of Microsoft Office applications, organizational and communication skills, excellent customer service skills.

Preferred Qualifications

Certification: CPR Certification.

Knowledge/Skills/Abilities: General knowledge of healthcare terminology and abbreviations, previous healthcare experience.

Physical Requirements

Majority of time involves sitting or standing; occasional walking, bending, stooping, and long periods of computer time at a workstation.

Light work that may include lifting or moving objects up to 20 pounds with or without assistance.

May be exposed to indoor environments with varied temperatures, air quality, lighting, and/or low to moderate noise.

Communicating with others to exchange information.

Visual acuity and hand-eye coordination to perform tasks.

Workspace may vary from open to confined.

May require travel to various facilities within and beyond the county perimeter; may require use of personal vehicle.

Benefits
Health First values diversity and inclusion, fostering a culture that recognizes, encourages, and respects the diverse voices of our associates. As an organization, we fuel innovation and connect closely with our associates, customers, and the communities we serve.

Schedule:

Full‑time
Shift Times:

9:00 am – 5:30 pm
Paygrade:

PG‑24

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