The Senior Patient Service Representative - PACT (Float Pool) at Cedars-Sinai Medical Network is a vital role within patient services. The role is an administrative professional responsible for coordinating the daily operations of patient services across multiple medical practice locations. The position involves handling patient check-in/check-out procedures, including collection and reconciliation of payments. Verifies insurance eligibility, assesses benefits and authorization requirements, and determines patient's out-of-pocket expenses. A solid understanding of all Health Information Management (HIM) related activities is integral to the role.

Duties and Responsibilities:

• Oversees check-in and check-out procedures for patients, including payment collection and reconciliation.
• Maintains and manages patient demographic and insurance information in the CS-Link system, ensuring data accuracy.
• Schedules and coordinates patient appointments, ensuring efficient patient flow and satisfaction.
• Uses in-depth knowledge of healthcare insurance and benefits to assess authorization requirements and patient's out-of-pocket expenses.
• Analyzes, evaluates, and resolves insurance issues by coordinating with insurance companies.
• Acts as liaison coordinating administrative support activities including facilities management, patient billing, utilization management, quality management, risk management, human resources, and payroll.
• Provides expert support in maintaining the physician master schedules and manage all changes as required, handling patient/provider correspondence as advised.
• Manages referrals and authorizations for various insurance types, ensuring that all patient interactions align with healthcare regulatory standards and Cedars-Sinai Medical Center's protocols.
• Assists in tracking, monitoring, and updating department-specific data as part of lean management processes.
• Assists with training and mentoring Patient Service Representatives, ensuring they are equipped to perform their duties effectively. Actively participate in departmental huddles and staff meetings, delivering presentations to improve positive and effective teamwork.
• Conducts patient care flow management and provide assistance in supervising CS-Link message pools.
• Uses detailed knowledge of the CS-Link/Epic Healthcare system to work independently and with minimal direction.
• Explains complex policies, procedures, or services to patients using administrative knowledge.
• Carries out lobby PSR role in all outpatient MDN departments. This requires learning and understanding of various EPIC functionalities, knowledge and skilled specific to the covering clinic. Adapts to the workflows and procedures of different practices.
• Assist with special projects or additional tasks as required by the practice manager or healthcare providers.

Education:

High school diploma/GED preferred

Experience:

Three (3) years of Patient Service Representative or Medical Assistant experience in an outpatient medical office setting required.