Patient Service Specialist PR - Outpatient Rehab Job at Health First in Orlando

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

1. Prepare charts for scheduled patients, obtain and verify authorizations, perform medical necessity, and ensure accurate orders are in place for all service lines.
2. 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.
3. 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). Issues ABN forms as needed.
4. Complete Medicare Secondary Payer Questionnaire (MSPQ) for Medicare beneficiaries.
5. Verify insurance eligibility and benefits through eligibility systems or contacts 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.
6. 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.
7. Attempt to collect patient cost-sharing amounts (e.g., co-pays, deductibles) and outstanding balances prior to service and post payments.
8. Ensure compliance with state and federal laws regarding all aspects of role.
9.  Proficient and able to function in all Registration environments.
10. Mentor staff and assists with training new staff on department specific procedures and applications.
11. Daily reconciliation of payment collections, preparation of bank deposits, and petty cash distribution.
12. Performs other duties as assigned.