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Pride Health · 1 hour ago

Customer Service Sales Representative

Worcester, MA

Full-time

Onsite

New Grad, Entry Level

$18/hr - $20/hr

Pride Health is a large Health System based out of Massachusetts, and they are seeking a Customer Service Sales Representative for a 13-week contract assignment. The role involves performing complex administrative duties for patients, assessing their needs, and facilitating appointments and services in an ambulatory setting.

Health CareHuman ResourcesInformation Technology

Growth Opportunities

Hiring Manager

Aastha (AB)

Responsibilities

Greets visitors and/or patients for scheduled and/or urgent care appointments and procedures

Confirms and verifies patient demographic and insurance information

May collect co-payments from patients upon arrival

Obtains signatures of consent from patient/guardian for treatment authorization and insurance/billing information

Assess patients’ needs, including but not limited to, financial counseling, interpreter services, social services and refers to appropriate person or area

Receives and directs phone calls

Connects the patient’s call to the provider or responds to the patient and takes messages as directed

Schedules urgent care appointments as needed and directed by clinicians

Schedules patients for treatment by multiple providers and treatment areas, and arranges a variety of associated tests and procedures according to established guidelines and specific criteria

Prioritizes appointments in a manner that fosters optimum patient care, efficient utilization of clinical staff, as well as resources

Ensures tests and procedural prep information is provided to patients verbally, mail, and/or by the patient portal as necessary

Collaborates with insurers to obtain patients’ prior-authorizations for procedures and tests as needed

Follows guidelines established by insurers to ensure that pre-authorization, pre-certification, and clinician referrals for treatment are obtained prior to patient visits

Complies with referral management regulations

Verifies eligibility for procedures or tests from various health care institutions

Follows up to correct discrepancies

May facilitate patient prescription renewal matters, (via telephone, fax, and email), within scope of authority as directed by clinicians

Preps the patient’s information for clinicians for scheduled patient visits as needed

Scrubs Patient Encounter information and submits electronically

Reviews and audits billing discrepancy reports and researches errors for resolution as directed by office or clinical management

Maintains accurate and timely records, logs, charges, files, and other related information as required

Performs a variety of related administrative and clerical duties, such as retrieving files distributing mail and other records, faxing, collating, data entry, and relaying messages to clinicians, residents and staff

May prepare special reports or spreadsheets for clinicians as requested

Collects co-payments from patients for visits, maintains records or makes daily cash deposits from patient visits

Calculates daily totals of co-payments received for submission to the second tier for co-payment reconciliation

Composes, or selects standard form letters for clinician’s response to routine inquiries and procedures, such as back-to-school authorizations