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Staff Job Composite

Patient Relations Representative

JOB DESCRIPTION

Job Summary: Under general direction, responds to patients and insurance company inquiries, questions, and concerns regarding registration, billing, and collection; analyzes data; prepares reports; compiles financial statements; determines patients’ financial status; serves as a liaison between medical and support staff for billing and collections issues.

CHARACTERISTIC JOB TASKS AND RESPONSIBILITIES
May include any and/or all of the following:

  1. Responds to patient and insurance company inquiries regarding physician bills; reviews patient account information; conducts insurance company inquiries; analyzes and interprets account data; serves as a resource person for billing information to patients, insurance companies, physicians, and office staff; posts demographic or financial entries on line; documents action and posts comments on billing system; logs and monitors daily inquiries.
  2. Responds to patient/guarantor correspondence to resolve questions/concerns; provides management with information and documentation; assists patients with concerns related to registration, collection, and medication assistance; documents trends, concerns, and issues; examines and interprets medical records.
  3. Prepares reports; compiles financial statements; performs financial assessments and screening on uninsured or underinsured patients; establishes payment arrangements for patients and communicates agreements; serves as a resource person to clinical departments for debt status of patients.
  4. Serves as liaison between medical and support staff regarding billing and collection issues and patients’ medical information.
  5. Researches and reviews data to ensure accuracy of accounts and balances; performs special projects and other duties as assigned.

KNOWLEDGE, SKILLS, ABILITIES AND PERSONAL CHARACTERISTICS

  • Knowledge of University Medical Group policies and procedures
  • Knowledge of patient accounting function
  • Knowledge of Medicare/Medicaid billing and collection regulations
  • Knowledge of HMO/PPO billing and collection procedures
  • Decision-making skills
  • Interpersonal/human relations skills
  • Ability to maintain confidentiality
  • Ability to work independently
  • Ability to analyze and interpret account data
  • Ability to maintain accuracy

MINIMUM QUALIFICATIONS
Education and experience equivalent to:

Training equivalent to one (1) year beyond high school; supplemented with three (3) years of previous related experience.

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