State of Washington Classified Job Specification
PATIENT SERVICES REPRESENTATIVE
Class Series Concept
Coordinates and provides patient support services such as scheduling appointments, answering telephones, receiving patients, registering patients, and processing patient charge documents in a patient care area.
Provides support services in a patient care area such as scheduling patient appointments, triaging patient telephone calls to medical staff, registering patients, providing point-of-service admission, maintaining patient records and assembling patient charts, initiating and processing patient charge documents, and transcribing physicians’ orders.
Under general supervision, performs specialized clerical and technical duties in a patient care area to facilitate the delivery of services provided.
Registers patients; collects and/or updates demographic and financial information; evaluates patient financial status to determine eligibility for care; assigns appropriate payer plans; obtains insurance claim forms and agency authorizations; verifies eligibility and benefits for third-party payers for planned and emergency admissions;
Responds to patient questions; provides directions to specified areas such as various labs, parking and eating facilities; assists patient in accessing hospital and community services by consulting and making referrals to appropriate resources; assists patients and families with telephone calls; maintains confidentiality of patient information;
Makes telephone assessment of patient problem and severity of condition; schedules new, return, ancillary and procedure appointments consistent with patient needs and scheduling guidelines; ensures or obtains authorization; completes required documentation; enters appointment information in on-line appointment system; maintains system by entering cancelled and rescheduled appointments;
Triages patient telephone calls to medical staff; obtains necessary information for the return call; initiates emergency procedure when necessary;
Communicates various types of information to patients, referral agencies, departments, physicians and the community such as financial arrangements for special programs and experimental protocols, hospital charge estimates, insurance coverage and billing procedures;
Initiates and maintains the organization of the patient chart; coordinates patient records, referrals, special forms, and charge documents to facilitate patient check-in and check-out;
Processes and reconciles patient charge documents, ensuring accuracy; investigates and corrects rejected charges;
Coordinates obtaining interpreters for patients;
Arranges for patient transportation to outside facilities; coordinates patient transportation within facility;
Transcribes, verifies and follows-up written physician orders; processes patient care orders such as completed requisition for exams or equipment;
Performs general clerical duties such as answering and screening telephone calls, processing mail, assembling and sending information to patients, inventorying, ordering, and stocking supplies;
Secures and releases patient valuables and belongings;
Coordinates death procedures, including disposition; completes appropriate documentation;
Performs related duties as required.
There may be instances where individual positions must have additional licenses or certification. It is the employer’s responsibility to ensure the appropriate licenses/certifications are obtained for each position.
High school graduation or equivalent
two years of general office experience or one year of office or customer service experience in a healthcare setting.
Class Specification History
New Class: 2-15-91
Revise Class: 1-19-2001
General revision. Revises class code (formerly 6077), typical work; effective July 1, 2007.