Patient Service Representative – Inpatient/Surgery Preservice Verification

This is a fully remote position, open to applicants in North Carolina.

📋 Description

• Ensure the accuracy and completeness of patient accounts in accordance with departmental protocols, policies, procedures, and regulatory standards.

• Execute pre-admission, admission, pre-registration, and registration tasks.

• Confirm insurance coverage, benefits, requirements, authorizations, referrals, and payment sources prior to patient arrival.

• Inform patients about their financial responsibilities, including balances, co-pays, coinsurance, and deductibles.

• Arrange payment options and initiate appropriate collection actions.

• Screen uninsured patients for potential government funding sources and refer them to Financial Services.

• Investigate accident-related conditions to ascertain liability and payment sources.

• Schedule and pre-register patients, ensuring the correction of demographic and financial data.

• Address insurance claim rejections and denials effectively.

• Assess diagnoses for adherence to the Local Medicare Review Policy.

• Clarify billing and insurance information to patients in line with PRMO policies.

• Identify third-party sponsorship and process patients according to established policies and procedures.

• Review insurance and sponsorship documentation for payment sources.

• Notify attending physicians of any patient financial hardships.

• Update patient insurance information within the billing system.

• Provide prompt customer service to internal clients, patients, payors, and physicians via telephone.

• Engage with insurance carriers regarding clinical information, coverage, payment, and benefits.

• Enter and update referrals, documenting authorizations in the billing system.

• Support departmental operations as needed.

⛳️ Requirements

• Exceptional oral and written communication abilities.

• Capability to analyze data, handle multiple tasks simultaneously, and work independently.

• Proficiency in developing and sustaining professional, service-oriented relationships with patients, physicians, colleagues, and supervisors.

• Understanding and adherence to policies and procedures.

• Knowledge of basic grammar and mathematical principles typically acquired through high school education.

• Additional training or a working knowledge of related business practices.

• Two to five years of experience in hospital access, physician office, billing and collections, or equivalent relevant education and/or experience.

• Postsecondary education is preferred.

• No specific degrees, licenses, or certifications are required.

🏝️ Benefits

• Opportunity to work remotely.

• Monday to Friday work schedule, from 8:30 am to 5:00 pm.

• Commitment to equal opportunity employment.

• Provisions for reasonable accommodations.