Patient Service Specialist I
Position Summary To be fully engaged in providing exceptional Quality/No Harm, Customer Experience, and Stewardship to ensure 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 Register patients by using two patient identifiers (name, date of birth) 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 in order to determine coverage.
Identify patients who may need Medicare Advance Beneficiary Notices of Noncoverage (ABNs).
Issue ABN forms as needed Complete Medicare Secondary Payer Questionnaire (MSPQ) for Medicare beneficiaries Verify insurance eligibility and benefits through eligibility systems or contact insurance companies by 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 Maintain established quality assurance and productivity benchmarks while utilizing best practice standards Ensure compliance with state and federal laws regarding all aspects of role MINIMUM QUALIFICATIONS Education:
High School diploma or equivalent Licensure:
N/A Certification:
CPR Certification ( American Heart Association HeartSaver CPR/AED Certification) Work
Experience:
One year customer service experience
Knowledge/Skills/Abilities:
o Excellent communication/interpersonal skills and professional presence o Working knowledge of Microsoft Office-Outlook, Word, Excel o Ability to work autonomously with minimal supervision o Ability to apply logic and common sense to identify issues related to work performed o Foundational critical thinking skills o Ability to maintain composure in stressful work environment o Ability to prioritize and organize to maximize quality, value, and service o Ability to adapt to a potentially rapid changing environment or work process o Excellent teamwork and collaboration skills o Successfully completes all required training programs, in-services, and annual competency validation within designated time frames PREFERRED QUALIFICATIONS Education:
High School diploma or equivalent Licensure:
N/A Certification:
N/A Work
Experience:
2-3 years office/customer service experience
Knowledge/Skills/Abilities:
o General knowledge of healthcare terminology o Experience working in multiple computer systems simultaneously o Strong organizational skills PHYSICAL REQUIREMENTS Physically agile; may require walking, standing running, bending, stooping, kneeling, climbing or crouching frequently Medium work that may include lifting or moving objects up to 50 pounds of force occasionally, with or without assistance May require moving self in different positions to accomplish tasks in various environments including tight and confined spaces, including reaching out and above shoulders or over head May lift, turn, pull, push, or ambulate people and/or equipment with or without assistance up to 90% of the assigned shift May be exposed to inside and outside environments with varied temperatures, air quality, lighting and/or low to loud noise May require working with biohazards such as blood/body fluids and airborne particles following OSHA and CDC Guidelines.
Communicating with others to exchange information.
Visual acuity and hand-eye coordination to perform tasks Workspace may vary from open to confined; on site or remote May require travel to various facilities within and beyond county perimeter; may require use of personal vehicle Job:
Registration Organization:
Health First Shared Svcs Inc Title:
Patient Service Specialist I Location:
Florida - Brevard County-Palm Bay Requisition ID:
068165 Recommended Skills Adaptability Advanced Cardiovascular Life Support (Acls) Agile Methodology Cpr Calculations Communication Estimated Salary: $20 to $28 per hour based on qualifications.
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 Register patients by using two patient identifiers (name, date of birth) 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 in order to determine coverage.
Identify patients who may need Medicare Advance Beneficiary Notices of Noncoverage (ABNs).
Issue ABN forms as needed Complete Medicare Secondary Payer Questionnaire (MSPQ) for Medicare beneficiaries Verify insurance eligibility and benefits through eligibility systems or contact insurance companies by 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 Maintain established quality assurance and productivity benchmarks while utilizing best practice standards Ensure compliance with state and federal laws regarding all aspects of role MINIMUM QUALIFICATIONS Education:
High School diploma or equivalent Licensure:
N/A Certification:
CPR Certification ( American Heart Association HeartSaver CPR/AED Certification) Work
Experience:
One year customer service experience
Knowledge/Skills/Abilities:
o Excellent communication/interpersonal skills and professional presence o Working knowledge of Microsoft Office-Outlook, Word, Excel o Ability to work autonomously with minimal supervision o Ability to apply logic and common sense to identify issues related to work performed o Foundational critical thinking skills o Ability to maintain composure in stressful work environment o Ability to prioritize and organize to maximize quality, value, and service o Ability to adapt to a potentially rapid changing environment or work process o Excellent teamwork and collaboration skills o Successfully completes all required training programs, in-services, and annual competency validation within designated time frames PREFERRED QUALIFICATIONS Education:
High School diploma or equivalent Licensure:
N/A Certification:
N/A Work
Experience:
2-3 years office/customer service experience
Knowledge/Skills/Abilities:
o General knowledge of healthcare terminology o Experience working in multiple computer systems simultaneously o Strong organizational skills PHYSICAL REQUIREMENTS Physically agile; may require walking, standing running, bending, stooping, kneeling, climbing or crouching frequently Medium work that may include lifting or moving objects up to 50 pounds of force occasionally, with or without assistance May require moving self in different positions to accomplish tasks in various environments including tight and confined spaces, including reaching out and above shoulders or over head May lift, turn, pull, push, or ambulate people and/or equipment with or without assistance up to 90% of the assigned shift May be exposed to inside and outside environments with varied temperatures, air quality, lighting and/or low to loud noise May require working with biohazards such as blood/body fluids and airborne particles following OSHA and CDC Guidelines.
Communicating with others to exchange information.
Visual acuity and hand-eye coordination to perform tasks Workspace may vary from open to confined; on site or remote May require travel to various facilities within and beyond county perimeter; may require use of personal vehicle Job:
Registration Organization:
Health First Shared Svcs Inc Title:
Patient Service Specialist I Location:
Florida - Brevard County-Palm Bay Requisition ID:
068165 Recommended Skills Adaptability Advanced Cardiovascular Life Support (Acls) Agile Methodology Cpr Calculations Communication Estimated Salary: $20 to $28 per hour based on qualifications.
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