patient relations representative

AlignRx

AlignRx is a Public Benefit LLC (PBLLC)&mdash;a for-profit limited liability company that is intended to produce a public benefit and to operate in a sustainable manner. We are the only PSAO to establish itself as this type of legal entity, as we are deeply committed to promoting the interests of community pharmacies. You can count on us to be transparent, accountable, and passionate.As an independently owned PSAO, we want community pharmacy owners to have maximum flexibility in their buy-side choices so they can maintain control over their business. AlignRx does not require pharmacy owners to purchase from a specific wholesaler or buying group. This benefit is just one more reason that community pharmacies experience peace of mind knowing our interests are in sync with theirs.Our mission is to support community pharmacy by offering innovative products and services that are best in class and designed to promote the pharmacies we serve as essential healthcare providers resulting in improved patient care and outcomes.Job SummaryWithin the Pharmacy Services Department, the Provider Relations Representative is responsible for providing support to pharmacy members seeking assistance or information regarding: contracted PBMs and health plans, payment rates and reimbursement status, claims processing and reconciliation, and all AlignRx programs and services. The position utilizes tools, resources, and guides to provide prompt and accurate addressing of questions and resolution of issues. The Provider Relations Representative often works closely with the PBM Account Executive and Senior PBM Account Executive on PBM and health plan issues.Essential Job Functions1. Serve as the front-line contact for AlignRx pharmacy members requesting information on, assistance with, or explanation of claims processing issues, AlignRx PSAO contracts, pharmacy not-contracted, direct contracting, claims pricing, claims reconciliation, and missing data, etc. (requests received via pharmacy member service calls, emails, or faxes).2. Maintain knowledge of existing and newly launched AlignRx programs and services, including mastering content of AlignRx programs and services guides for the purpose of servicing pharmacy members.3. Conduct data pulls to validate contract information.4. Follow up on eRecon and Central Pay issues for pharmacy members.5. Follow defined work plans and leadership direction to meet due dates when addressing pharmacy member concerns or adverse issues.6. Abide by department workflow, policies, and procedures.7. Remain current on pharmacy industry trends and aware of AlignRx pharmacy member business needs and concerns.8. Monitor and address issues from Customer Support email box.9. Document call and work activity in the Pharmacy Data Management System (PDMS) and review Daily Notes report to ensure follow-up and resolution.10. Attend and actively participate in Provider Relations team meetings.11. Provide support to other team members, as needed.Additional Responsibilities<ul><li>Perform other duties or projects as assigned by senior management.</li></ul>Minimum Qualifications for Consideration<ul><li>Bachelor&rsquo;s degree in a business-related field preferred.</li><li>Two to three years as a pharmacy technician in a retail pharmacy environment.</li></ul>Knowledge, Skills, and Abilities:<ul><li>Excellent verbal and written communication skills</li><li>Good interpersonal skills: able to work and communicate effectively with all levels of co-workers, clients, and other external contacts</li><li>Strong organizational and time management skills</li><li>Dependable with good attendance and adherence to timelines and schedules</li><li>Strong analytical skills</li><li>Good problem-solving skills</li><li>Consistent follow-through on issue resolution</li><li>Resourceful, with the ability to take initiative in development and completion of projects</li><li>Strong sense of customer service</li><li>Basic computer knowledge through effective use of a personal computer including Microsoft Office applications, specifically: file management skills, Internet, Microsoft Windows, database, word processing (Word), spreadsheets (Excel), presentation software (PowerPoint), graphics</li><li>Knowledge of and experience in the pharmacy and healthcare industry regarding terminology and retail pharmacy operations, including understanding of how and why pharmacy claims process (e.g., calculation of copayments, pricing hierarchies)</li><li>Basic drug knowledge and understanding of Therapeutic Categories (TC), Multi-Source Indicators (MSI), Generic Product Identifier (GPI), Generic Code Number (GCN), Drug/claim statuses: Paid vs. Captured; PDL/NPDL; &ldquo;F&rdquo; &ndash; Formulary (paid) vs. &ldquo;G&rdquo; &ndash; Non-formulary paid</li></ul>Physical Requirements/Working Conditions<ul><li>Sedentary work, requiring the following physical activities: sitting for long periods of time; occasional bending, squatting, kneeling, stooping; good finger dexterity and feeling; frequent repetitive motions; talking, hearing, and visual acuity</li><li>Lifting of up to 20 pounds of paper supplies or minor office equipment</li><li>Conducting work in a business-type environment (e.g., desk, table) that can facilitate the use of two computer monitors</li><li>Remote</li></ul>SalaryStarting at $20.00 an hour, based on experienceBenefits:<ul><li>401(k)</li><li>401(k) matching</li><li>Dental insurance</li><li>Employee assistance program</li><li>Flexible spending account</li><li>Health insurance</li><li>Health savings account</li><li>Life insurance</li><li>Paid time off</li><li>Tuition reimbursement</li><li>Vision insurance</li></ul>NOTE: The above statements are intended to describe the general nature and level of work performed by an employee in this position. These statements are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of employees in this position.AlignRx is an equal opportunity employer and is committed to providing a workplace free from harassment and discrimination. We celebrate unique differences of our employees, knowing diversity drives innovation, and the success of our business. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, gender identity or expression, age, marital status, veteran status, disability status, pregnancy, parental status, genetic information, political affiliation, or any other status protected by applicable laws or regulations.Experience:<ul><li>Pharmacy technician in a retail environment: 2 years (Required)</li></ul>Work Location: RemotePay: From $20.00 per hourBenefits:<ul><li>401(k)</li><li>401(k) matching</li><li>Dental insurance</li><li>Employee assistance program</li><li>Health insurance</li><li>Health savings account</li><li>Life insurance</li><li>Paid time off</li><li>Retirement plan</li><li>Tuition reimbursement</li><li>Vision insurance</li></ul>Experience:<ul><li>Pharmacy technician in a retail environment: 2 years (Required)</li></ul>Work Location: Remote

Provider Relations Representative

Al Nasr Driving Academy

IMMEDIATE REQUIREMENT!!!We are seeking a dedicated and experienced Supervisor with a minimum of 3 years of experience in Patient Relations and SPA operations. The ideal candidate will be responsible for overseeing daily operations, ensuring high standards of customer service, and maintaining a positive client experience.JOB TITLE: Supervisor &ndash; Patient Relations &amp; SPAJOB TYPE: Full TimeWORKING HOURS: 08 hours/dayLOCATION: (Doha) QatarPAY RANGE: To be discussedLANGUAGE: English (Required)Experience: Minimum 3 years of experience in Patient Relations and SPAKey Responsibilities:<ul><li>Supervise and manage daily operations of Patient Relations and SPA departments</li><li>Ensure excellent customer service and patient/client satisfaction at all times</li><li>Handle customer inquiries, complaints, and feedback professionally</li><li>Train, guide, and monitor staff performance</li><li>Maintain hygiene, safety, and quality standards in SPA and patient service areas</li><li>Coordinate with management to improve service quality and efficiency</li><li>Prepare reports and maintain proper documentation</li></ul>Requirements:<ul><li>Minimum 3 years of experience in Patient Relations and SPA</li><li>Strong communication and interpersonal skills</li><li>Leadership and team management abilities</li><li>Ability to handle customer concerns effectively</li><li>Professional appearance and positive attitude</li><li>Knowledge of healthcare or wellness industry is an advantage</li></ul>If you are interested feel free to reach me at (Email:careers.alnasrstargroup@gmail.com)About us:AL NASR STAR GROUP is part of a prominent group of businesses exceling in Security, Cleaning &amp; Hospitality, manpower supply, recruitment of both white collar and blue collar, Contracting &amp; Real Estate.Our fully integrated management system and adherence to high quality standards of service enables Al Nasr Star Group to maintain it's distinctive reputation. The scope of our service, depth of experience and the quality of our people has positioned us at the front of the pack.Job Type: Full-timePay: QAR4,000.00 - QAR5,000.00 per monthExperience:<ul><li>SUPERVISOR: 3 years (Required)</li></ul>Language:<ul><li>English (Required)</li></ul>Work Location: In person

Supervisor – Patient Relations & SPA

Texas Oncology

<div>Overview:<div></div><div> 
The US Oncology Network is looking for a Patient Benefits Representative to join our team at Texas Oncology. This full-time position will support the Revenue Cycle Department at our 3010 Harrison Avenue clinic in Beaumont, Texas with some travel. Typical work week is Monday through Friday, 8:30a - 5:00p.</div><div></div> 
This position will be a level 1or Sr depending on relevant candidate experience.<div> 
As a part of The US Oncology Network, Texas Oncology delivers high-quality, evidence-based care to patients close to home. Texas Oncology is the largest community oncology provider in the country and has approximately 530 providers in 280+ sites across Texas, our founders pioneered community-based cancer care because they believed in making the best available cancer care accessible to all communities, allowing people to fight cancer at home with the critical support of family and friends nearby. Our mission is still the same today&mdash;at Texas Oncology, we use leading-edge technology and research to deliver high-quality, evidence-based cancer care to help our patients achieve &ldquo;More breakthroughs. More victories.&rdquo; &reg; in their fight against cancer. Today, Texas Oncology treats half of all Texans diagnosed with cancer on an annual basis.</div><div></div><div> 
The US Oncology Network is one of the nation&rsquo;s largest networks of community-based oncology physicians dedicated to advancing cancer care in America. The US Oncology Network is supported by McKesson Corporation focused on empowering a vibrant and sustainable community patient care delivery system to advance the science, technology, and quality of care.</div><div></div> 
What does the Patient Benefits Representative do? (including, but not limited to):
The Patient Benefits Representative, under general supervision is responsible for educating patient on insurance coverage and benefits. Assess patients financial ability; may educate patient on assistance programs. Updates and maintains existing patient new insurance eligibility, coverage, and benefits in system. Supports and adheres to the US Oncology Compliance Program, to include the Code of Ethics and Business Standards, and US Oncology&rsquo;s Shared Values.
Responsibilities:

The essential duties and responsibilities (including, but not limited to):<ul><li>
Prior to a patient receiving treatment; obtains insurance coverage information and demographics; educates patient on insurance coverage, benefits, co-pays, deductibles, and out-of-pocket expenses.
</li><li>Assess patients ability to meet expenses and discusses payment arrangements. May educate patients on financial assistance programs as well as identify sources and provide assistance with completing forms. Based upon diagnosis, estimated insurance coverage, and financial assistance, completes Patient Cost Estimate form.
</li><li>Completes appropriate reimbursement and liability forms for patient&rsquo;s review and signature. Forwards appropriate information and forms to billing office.</li><li>
Responsible for obtaining, from Clinical Reviewer, insurance pre-authorization or referral approval codes prior to each treatment.</li><li>
Review patient account balance and notify front desk of patients to meet with</li><li>
Ensure that patient co-pay amount is correctly entered into system (or conveyed), allowing front desk to collect appropriately</li><li>
At each patient visit, verifies and updates demographics and insurance coverage in computer system according to Standard Operating Procedures (SOPs).
</li><li>Stays current on available financial aide. Develops professional relationships with financial aide providers. Networks with financial aide providers to obtain leads to other aide programs.</li><li>
Adheres to confidentiality, state, federal, and HIPPA laws and guidelines with regards to patient*s records.
</li><li>Maintains updated manuals, logs, forms, and documentation. Performs additional duties as requested.
</li><li>Other duties as requested or assigned.</li></ul>
Qualifications:

The ideal candidate for the Patient Benefits Representative will have the following background and experience:
 Level 1<ul><li>
High school diploma or equivalent required.
</li><li>Minimum three (3) years patient pre-services coordinator or equivalent required.
</li><li>Proficiency with computer systems and Microsoft Office (Word and Excel) required.
</li><li>Demonstrate knowledge of CPT coding and HCPS coding application.</li><li>
Must be able to verbally communicate clearly and utilize the appropriate and correct terminology.</li><li>
Must successfully complete required e-learning courses within 90 days of occupying position.</li></ul>
Level Sr (in addition to level 1 requirements)<ul><li>
Associates degree in Finance, Business or four years revenue cycle experience preferred.
</li><li>Minimum three (3) years pre-services coordinator experience and two (2) years of patient benefits experience required.
</li><li>Must be able to demonstrate knowledge and appropriate application of insurance coverage benefits and terminology.</li></ul> 
Competencies:<ul><li>
Uses Technical and Functional Experience: Possesses up to date knowledge of the profession and industry; is regarded a san expert in the technical/functional area; accesses and uses other expert resources when appropriate.</li><li>
Demonstrates Adaptability: Handles day to day work challenges confidently; is willing and able to adjust to multiple demands, shifting priorities, ambiguity and rapid change; shows resilience inn the face of constraints, frustrations, or adversity; demonstrates flexibility.</li><li>
Uses Sound Judgment: Makes timely, cost effective and sound decisions; makes decisions under conditions of uncertainty.</li><li>
Shows Work Commitment: Sets high standards of performance; pursues aggressive goals and works efficiently to achieve them.</li><li>
Commits to Quality: Emphasizes the need to deliver quality products and/or services; defines standards for quality and evaluated products, processes, and service against those standards; manages quality; improves efficiencies.</li></ul>
Physical Demands:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is required to be present at the employee site during regularly scheduled business hours and regularly required to sit or stand and talk or hear. Requires full range of body motion including handling and lifting patients, manual and finger dexterity, and eye-hand coordination. Requires standing and walking for extensive periods of time. Occasionally lifts and carries items weighing up to 40 lbs. Requires corrected vision and hearing to normal range. 
Work Environment:<div>
The work environment may include exposure to communicable diseases, toxic substances, ionizing radiation, medical preparations and other conditions common to an oncology/hematology clinic environment. Work will involve in-person interaction with co-workers and management and/or clients. Work may require minimal travel by automobile to office sites.</div></div>

Patient Benefits Representative Sr

<div>Overview:<div></div><div> 
The US Oncology Network is looking for a Patient Benefits Representative to join our team at Texas Oncology. This full-time position will support the Oncology Department at our 1901 S. 2nd Street clinic in McAllen, Texas. Typical work week is Monday through Friday working eight hours betwee 7:30a - 5:00p.</div><div></div> 
This position will be a level 1or Sr depending on relevant candidate experience.<div> 
As a part of The US Oncology Network, Texas Oncology delivers high-quality, evidence-based care to patients close to home. Texas Oncology is the largest community oncology provider in the country and has approximately 530 providers in 280+ sites across Texas, our founders pioneered community-based cancer care because they believed in making the best available cancer care accessible to all communities, allowing people to fight cancer at home with the critical support of family and friends nearby. Our mission is still the same today&mdash;at Texas Oncology, we use leading-edge technology and research to deliver high-quality, evidence-based cancer care to help our patients achieve &ldquo;More breakthroughs. More victories.&rdquo; &reg; in their fight against cancer. Today, Texas Oncology treats half of all Texans diagnosed with cancer on an annual basis.</div><div></div><div> 
The US Oncology Network is one of the nation&rsquo;s largest networks of community-based oncology physicians dedicated to advancing cancer care in America. The US Oncology Network is supported by McKesson Corporation focused on empowering a vibrant and sustainable community patient care delivery system to advance the science, technology, and quality of care.</div><div></div> 
What does the Patient Benefits Representative do? (including, but not limited to):
The Patient Benefits Representative, under general supervision is responsible for educating patient on insurance coverage and benefits. Assess patients financial ability; may educate patient on assistance programs. Updates and maintains existing patient new insurance eligibility, coverage, and benefits in system. Supports and adheres to the US Oncology Compliance Program, to include the Code of Ethics and Business Standards, and US Oncology&rsquo;s Shared Values.
Responsibilities:

The essential duties and responsibilities (including, but not limited to):<ul><li>
Prior to a patient receiving treatment; obtains insurance coverage information and demographics; educates patient on insurance coverage, benefits, co-pays, deductibles, and out-of-pocket expenses.
</li><li>Assess patients ability to meet expenses and discusses payment arrangements. May educate patients on financial assistance programs as well as identify sources and provide assistance with completing forms. Based upon diagnosis, estimated insurance coverage, and financial assistance, completes Patient Cost Estimate form.
</li><li>Completes appropriate reimbursement and liability forms for patient&rsquo;s review and signature. Forwards appropriate information and forms to billing office.</li><li>
Responsible for obtaining, from Clinical Reviewer, insurance pre-authorization or referral approval codes prior to each treatment.</li><li>
Review patient account balance and notify front desk of patients to meet with</li><li>
Ensure that patient co-pay amount is correctly entered into system (or conveyed), allowing front desk to collect appropriately</li><li>
At each patient visit, verifies and updates demographics and insurance coverage in computer system according to Standard Operating Procedures (SOPs).
</li><li>Stays current on available financial aide. Develops professional relationships with financial aide providers. Networks with financial aide providers to obtain leads to other aide programs.</li><li>
Adheres to confidentiality, state, federal, and HIPPA laws and guidelines with regards to patient*s records.
</li><li>Maintains updated manuals, logs, forms, and documentation. Performs additional duties as requested.
</li><li>Other duties as requested or assigned.</li></ul>
Qualifications:

The ideal candidate for the Patient Benefits Representative will have the following background and experience:
 Level 1<ul><li>
High school diploma or equivalent required.
</li><li>Minimum three (3) years patient pre-services coordinator or equivalent required.
</li><li>Proficiency with computer systems and Microsoft Office (Word and Excel) required.
</li><li>Demonstrate knowledge of CPT coding and HCPS coding application.</li><li>
Must be able to verbally communicate clearly and utilize the appropriate and correct terminology.</li><li>
Must successfully complete required e-learning courses within 90 days of occupying position.</li></ul>
Level Sr (in addition to level 1 requirements)<ul><li>
Associates degree in Finance, Business or four years revenue cycle experience preferred.
</li><li>Minimum three (3) years pre-services coordinator experience and two (2) years of patient benefits experience required.
</li><li>Must be able to demonstrate knowledge and appropriate application of insurance coverage benefits and terminology.</li></ul> 
Competencies:<ul><li>
Uses Technical and Functional Experience: Possesses up to date knowledge of the profession and industry; is regarded a san expert in the technical/functional area; accesses and uses other expert resources when appropriate.</li><li>
Demonstrates Adaptability: Handles day to day work challenges confidently; is willing and able to adjust to multiple demands, shifting priorities, ambiguity and rapid change; shows resilience inn the face of constraints, frustrations, or adversity; demonstrates flexibility.</li><li>
Uses Sound Judgment: Makes timely, cost effective and sound decisions; makes decisions under conditions of uncertainty.</li><li>
Shows Work Commitment: Sets high standards of performance; pursues aggressive goals and works efficiently to achieve them.</li><li>
Commits to Quality: Emphasizes the need to deliver quality products and/or services; defines standards for quality and evaluated products, processes, and service against those standards; manages quality; improves efficiencies.</li></ul>
Physical Demands:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is required to be present at the employee site during regularly scheduled business hours and regularly required to sit or stand and talk or hear. Requires full range of body motion including handling and lifting patients, manual and finger dexterity, and eye-hand coordination. Requires standing and walking for extensive periods of time. Occasionally lifts and carries items weighing up to 40 lbs. Requires corrected vision and hearing to normal range. 
Work Environment:<div>
The work environment may include exposure to communicable diseases, toxic substances, ionizing radiation, medical preparations and other conditions common to an oncology/hematology clinic environment. Work will involve in-person interaction with co-workers and management and/or clients. Work may require minimal travel by automobile to office sites.</div></div>

Patient Benefits Representative

The Queen's Medical Center

<div>RESPONSIBILITIES<div> 
I. JOB SUMMARY/RESPONSIBILITIES: 
<ul><li>As an initial and final point of contact, the Guest Services Representative (GSR) represents the brand and image of The Queen&rsquo;s Medical Center - Manamana and The Queen&rsquo;s Health System (QHS) using the CARE values of Compassion, Aloha, Respect and Excellence, and AIDET methodologies.</li><li>In partnership with Volunteers, Lobby Staff, Environmental Services and Security, maintains a welcoming lobby experience with a priority focused on safety, service excellence and attention to detail.</li><li>In a warm and friendly manner, provides patients and visitors with general information, escorting and wayfinding support, and assistance with patient/visitor complaints, problems, or special needs.</li></ul> 
II. TYPICAL PHYSICAL DEMANDS: 
<ul><li>Sitting, finger dexterity, seeing, hearing, speaking.</li><li>Frequent: standing, walking, lifting, pushing and carrying usual weight up to 25 pounds, pushing/pulling patient in wheel chair up to 25 pounds of force, stooping/bending, climbing stairs, walking on uneven ground, twisting body, reaching above, at or below shoulders, repetitive arm/hand motion and frequent gripping of an object.</li></ul> 
III. TYPICAL WORKING CONDITIONS: 
<ul><li>Not substantially subjected to adverse environmental conditions.</li></ul> 
IV. MINIMUM QUALIFICATIONS: 
A. EDUCATION/CERTIFICATION AND LICENSURE: 
<ul><li>High School diploma or equivalent.</li></ul> 
B. EXPERIENCE: 
<ul><li>Ability to deal effectively with internal and external customers.</li><li>Ability to communicate effectively in English, both orally and in writing.</li><li>Knowledge of Microsoft Office applications, i.e. Word and Outlook.</li><li>Prior customer service experience in a hospital or hospitality setting preferred.</li></ul></div>
Equal Opportunity Employer / Disability / Vet 
Your Health. Our Legacy 
Our Mission: To fulfill the intent of Queen Emma and King Kamehameha IV to provide in perpetuity quality health care services to improve the well-being of Native Hawaiians and all of the people of Hawai&lsquo;i. 
Our Values: 
Compassion guides our actions 
Aloha inspires us in all that we do 
Respect and understanding are essential for the dignity of all 
Excellence is our quest</div>

Guest Services Representative - Patient Relations_QMCP (Call-In, Shift Varies)

SCA Health

<div>Overview:
<div>
At SCA Health, we believe health care is about people &ndash; the patients we serve, the physicians we support and the teammates who push us forward. Behind every successful facility, procedure or innovation is a team of 15,000+ professionals working together, learning from each other and living out the mission, vision and values that define our organization.</div><div></div><div> 
As part of Optum, SCA Health is redefining specialty care by developing more accessible, patient-centered practice solutions for a network of more than 370 ambulatory surgical centers, over 400 specialty physician practice clinics and numerous labs and surgical hospitals. Our work spans a broad spectrum of services, all designed to support physicians, health systems and employers in delivering efficient, value-based care to patients without compromising quality or autonomy.</div><div> 
</div><div>What sets SCA Health apart isn&rsquo;t just what we do, it&rsquo;s how we do it. Each decision we make is rooted in seven core values:</div><div></div><ul><li> 
Clinical quality</li><li>
Integrity</li><li>
Service excellence</li><li>
Teamwork</li><li>
Accountability</li><li>
Continuous improvement</li><li>
Inclusion</li></ul><div></div><div> 
Our values aren&rsquo;t empty words &ndash; they inform our attitudes, actions and culture. At SCA Health, your work directly impacts patients, physicians and communities. Here, you&rsquo;ll find opportunities to build your career alongside a team that values your expertise, invests in your success, and shares a common mission to care for patients, serve physicians and improve health care in America. 
</div><div></div><div>At SCA Health, we offer a comprehensive benefits package to support your health, well-being, and financial future. Our offerings include medical, dental, and vision coverage, 401k plan with company match, paid time off, life and disability insurance, and more. Please visit, https://careers.sca.health/why-sca, to learn more about our benefits.</div><div></div><div> 
Your ideas should inspire change. If you join our team, they will.</div>
Accountabilities / Responsibilities:
<div>
** The work schedule is Monday - Friday, with work hours from 9am - 5:30pm EST / 8am - 4:30pm CST **</div><div></div><div> 
The Patient Call Representative interfaces with patients primarily via inbound and outbound calls in order to assist them with inquiries the patient may have. The reps receive and/or collect payments and resolve their issue either through a one call interaction or by escalation and follow up.</div> 
<ul><li>
Take inbound calls from patients and make outbound calls to patients</li><li>
Provide one call resolution to patient inquires whenever possible and perform timely follow up on inquiries requiring escalation or additional research</li><li>
Follow up on all patient voicemails within 24 hours</li><li>
Provide patient education regarding how to understand their Explanation of Benefits (EOB)</li><li>
Take payments from patients</li><li>
Provide requested documentation and records</li><li>
Consistently achieve defined metrics</li><li>
Read and understand contracts with Insurance companies</li><li>
Review and determine if an adjustment is required on an account</li><li>
Review and determine if a refund is required on an account</li><li>
Verify insurance</li><li>
Provide patient estimates</li><li>
Verify and update demographic information</li><li>
Research and locate missing payments</li><li>
Review clinical information to determine if a coding review is required</li></ul>
Qualifications:
<ul><li>High school diploma or GED required</li><li>
Strong Call Center Customer Service experience is required</li><li>
A/R, billing, insurance verification or customer service experience is required</li><li>
Healthcare experience is required</li><li>
Bilingual preferred</li></ul> 
<div></div>
Min: USD $21.00/Hr. Max: USD $23.00/Hr.</div>

Associate Patient Call Representative

St. Luke's University Health Network

<div><h3 class="jobSectionHeader">St. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care.
</h3>HOURS :
Full Time, 40 hours/ week, Days.
Mon-Fri, with rotating Saturdays (every 3rd weekend)
Mon-Fri 6 AM - 2 PM
Saturday hours vary
Hours of operation are 6 AM - 8 PM 
The Patient Access Representative is responsible for the entire scope of the registration process for patients seen at St. Luke's University Health Network, in outpatient and/or Emergency Department locations. This includes, but is not limited to, correctly identifying patients, transcribing orders, completing registration screens, entering diagnosis and provider information, verifying insurances, point of service cash collections, work queues, etc. Communicates and coordinates with SLPG practices, clinical/diagnostic departments, and various revenue cycle departments to ensure excellent patient experience, clean claim submission, and payment for services. May require occasional travel between campuses or regional locations.
JOB DUTIES AND RESPONSIBILITIES:
<ul><li>Responsible to correctly identify/validate the choosing of patients in hospital information system to maintain the integrity and accuracy of electronic medical records. Identify and report any instances of possible identify theft situations to clinical department and leadership for appropriate escalation.
</li><li>Maintain knowledge and education of network policy on Patient Identification including Mark for Merge, Chart Corrections, and Patient Look-Up.
</li><li>Responsible for the patient registration (pre-reg and post-reg needs) including all of the following: demographics, emergency contact, transcribing diagnostic orders, primary care and referring provider, diagnosis, insurance and guarantor verification, real time insurance eligibility, point of service cash collections. This also includes patient, account, and claim edit level work queue errors related to registration. Can require contacting provider office, reviewing patient medical chart for diagnosis and medical necessity information.
</li><li>Required to cross train in all areas of location or region. Campus locations must be cross trained in outpatient and Emergency Department areas. Outpatient (off-campus) locations must be cross trained for all locations if any different nuances.
</li><li>Greets/directs patients and visitors for the entire facility. Always provides friendly and courteous service to community and co-workers. Responsible for monitoring and enforcing visitor policy for the entity (if applicable).
</li><li>Answers internal and external calls on main department/facility line and dispenses appropriate information and answers questions regarding the facility and its services.
</li><li>Promotes and helps increase usage of MyChart patient portal and patient self-service capabilities to ensure patients are personally engaging in their health care.
</li><li>Responsible for overseeing and assisting patients with Welcome Kiosk and On My Way technology at network locations. Consists of self-scheduled patients online and monitoring the arrival process and patient&rsquo;s journey throughout their visit.
</li><li>Responsible for contacting the SLPG practice or Network Prior Authorization Department to obtain required insurance referrals and pre-certs when not previously documented in chart prior to service to decrease denials for no authorization.
</li><li>Must obtain medical license Number, NPI and UPIN via appropriate website for all new provider entries for outpatient services to ensure results are routed accurately and claim submission/payment.
</li></ul>PHYSICAL AND SENSORY REQUIREMENTS:
Sitting/standing up to 8 hours per day, 4 or more hours at a time. Frequent use of hands/fingers for data entry. Frequently walking and ability to push up to 250 pounds in a wheelchair. Ability to occasionally carry or lift up to 15 pounds. Hearing as it relates to normal conversation. Seeing as it relates to general vision.
MINIMUM QUALIFICATIONS EDUCATION:
High school graduate or equivalent required. Certificate/Degree in health care related field preferred.
TRAINING AND EXPERIENCE :
Excellent customer service and interpersonal skills required. General computer experience and ability to type fluently, accurately, and quickly required. Insurance background preferred. Knowledge of medical terminology preferred. Previous medical administrative experience and/or health care related education courses preferred. Knowledge of health information system (epic) preferred.
Please complete your application using your full legal name and current home address. Be sure to include employment history for the past seven (7) years, including your present employer. Additionally, you are encouraged to upload a current resume, including all work history, education, and/or certifications and licenses, if applicable. It is highly recommended that you create a profile at the conclusion of submitting your first application. Thank you for your interest in St. Luke's!!
<h2 class="jobSectionHeader">St. Luke's University Health Network is an Equal Opportunity Employer.</h2></div>

OP Patient Access Representative (Full Time, Days)

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