What does a patient representative do?
A patient representative is responsible for assisting the patients with their health care needs by identifying their medical concerns, assessing their medical history, and referring them to the appropriate physicians or other medical professionals for immediate treatments and further examinations. Patient representatives verify the patients' insurance information, guiding them on filling out medical forms, processing payments for medical services, and updating them for the release of medical results. A patient representative must have excellent communication and organizational skills, especially when responding to patient's inquiries and concerns timely and accurately, and performing additional administrative and clerical tasks as needed.
Patient representative responsibilities
Here are examples of responsibilities from real patient representative resumes:
- Code preoperative patients' surgical procedures according to surgeon's operative order by using CPT code book.
- Develop physical and psychological rehabilitation programs for head trauma patients.
- Assist uninsured and under-insure hospital patients in applying for government benefits including Medicaid and charity care programs.
- Give patients preparations, take insurance information, and enter all necessary and relevant information into computer system.
- Schedule appointments -Answered phones -provide care and compassion for patients -handle payments and maintain a proper transaction report daily
- Greet patients upon arrival and pre-register visit ensuring patient does not have duplicate medical records.
- Bill medical claims electronically, review all claims to insure proper coding of ICD-9 and CPT codes.
- Communicate emergencies with clinical staff for immediate patient triage.
- Solicit personal private medical information from patients while practicing HIPPA.
- Maintain strict patient and physician confidentiality in accordance with HIPAA regulations.
- Coordinate telephone communications, and provide request information or triage call accordingly.
- Review and analyze EOB correspondence, ensuring accuracy of claims and information.
- Collect demographic information and insurance, verify insurance, accurately check patients into the hospital.
- Verify HIPAA to ensure patient confidentiality before confirming medication information and refill date accuracy.
- Conduct bi-monthly resident council meetings in the transitional care unit i.e., rehabilitation and hospice units.
Patient representative skills and personality traits
We calculated that 28% of Patient Representatives are proficient in Patients, Check-In, and Medical Terminology. They’re also known for soft skills such as Communication skills, Computer skills, and Customer-service skills.
We break down the percentage of Patient Representatives that have these skills listed on their resume here:
- Patients, 28%
Registered and scheduled patients to verify insurance and preparatory instructions for evaluation by 12 doctors and interns.
- Check-In, 8%
Coordinated check-in processes by contacting insurance providers to verify correct insurance information and get authorization for proper billing codes.
- Medical Terminology, 5%
Maintained statistical data and records, prepared special reports on medical claims; experienced in medical terminology.
- Patient Care, 5%
Track and analyze data to identify impediments to quality patient care and make recommendations for process improvement.
- Insurance Verification, 4%
Utilize insurance verification software to determine eligibility for service/financial responsibility.
- Patient Demographics, 3%
Prepared and pulled medical records for daily appointments, collected patient demographics for registration, verified insurances and processed referrals.
"patients," "check-in," and "medical terminology" are among the most common skills that patient representatives use at work. You can find even more patient representative responsibilities below, including:
Communication skills. One of the key soft skills for a patient representative to have is communication skills. You can see how this relates to what patient representatives do because "customer service representatives must be able to provide clear information in writing, by phone, or in person." Additionally, a patient representative resume shows how patient representatives use communication skills: "manage high volume patient calls with the patient communication center for all of ucla north west valley clinics. "
Customer-service skills. patient representatives are also known for customer-service skills, which are critical to their duties. You can see how this skill relates to patient representative responsibilities, because "representatives help companies retain customers by professionally answering questions and helping to resolve complaints." A patient representative resume example shows how customer-service skills is used in the workplace: "perform major clerical duties including maintenance of confidential patient charts assist doctors and patients with appointment scheduling multi-level customer assistance"
Interpersonal skills. patient representative responsibilities often require "interpersonal skills." The duties that rely on this skill are shown by the fact that "representatives should be able to create positive interactions with customers." This resume example shows what patient representatives do with interpersonal skills on a typical day: "trained in and maintained excellent interpersonal and communications skills that complement proven creative problem solving capabilities. "
Listening skills. Another crucial skill for a patient representative to carry out their responsibilities is "listening skills." A big part of what patient representatives relies on this skill, since "representatives must listen carefully to ensure that they understand customers in order to assist them." How this skill relates to patient representative duties can be seen in an example from a patient representative resume snippet: "communicated with medical insurance companies for approval. "
Patience. Another skill commonly found on patient representative job descriptions is "patience." It can come up quite often in patient representative duties, since "representatives should be patient and polite, especially when interacting with dissatisfied customers." Here's an example from a resume of how this skill fits into day-to-day patient representative responsibilities: "exercise of courtesy and patience in speaking with patients, families and others to maintain sound public relations. "
The three companies that hire the most patient representatives are:
- Children's Hospital Colorado106 patient representatives jobs
- HealthTrust69 patient representatives jobs
- UPMC53 patient representatives jobs
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Compare different patient representatives
Patient representative vs. Medical receptionist
Medical receptionists are responsible for manning the front desk at a medical facility such as a clinic or a hospital. They manage schedules and appointments in the clinic or hospital. They help patients to their respective appointments. They also assist doctors, nurses, and other medical practitioners by ensuring that the schedule for the day is being followed. They are also in charge of assisting visitors by directing them wherever they would need to go. Medical receptionists also answer inquiries by patients or visitors. Medical knowledge, great customer service skills, and a friendly attitude are needed.
There are some key differences in the responsibilities of each position. For example, patient representative responsibilities require skills like "patient appointments," "strong customer service," "excellent interpersonal," and "emr." Meanwhile a typical medical receptionist has skills in areas such as "office equipment," "insurance forms," "test results," and "provides administrative support." This difference in skills reveals the differences in what each career does.
Medical receptionists really shine in the health care industry with an average salary of $32,483. Comparatively, patient representatives tend to make the most money in the non profits industry with an average salary of $34,572.The education levels that medical receptionists earn slightly differ from patient representatives. In particular, medical receptionists are 2.8% less likely to graduate with a Master's Degree than a patient representative. Additionally, they're 0.1% less likely to earn a Doctoral Degree.Patient representative vs. Patient care specialist
A patient service or care specialist works at different medical facilities. Primary responsibilities include checking patients in and out, scheduling follow-up appointments as well as checking patient eligibility for services or programs. Patient service specialists should maintain a systematic referral log to correlate patient referrals to other specialists. Applicants for the job should have the basic computer knowledge to effectively manage data of patient's files, knowledge of medical terminologies, and possess good interpersonal and customer service skills.
Each career also uses different skills, according to real patient representative resumes. While patient representative responsibilities can utilize skills like "check-in," "patient registration," "strong customer service," and "excellent interpersonal," patient care specialists use skills like "cpr," "departmental policies," "quality care," and "provides administrative support."
Patient care specialists may earn a higher salary than patient representatives, but patient care specialists earn the most pay in the health care industry with an average salary of $32,483. On the other hand, patient representatives receive higher pay in the non profits industry, where they earn an average salary of $34,572.Average education levels between the two professions vary. Patient care specialists tend to reach similar levels of education than patient representatives. In fact, they're 0.2% more likely to graduate with a Master's Degree and 0.1% more likely to earn a Doctoral Degree.Patient representative vs. Patient liaison
Patient Liaisons are intermediaries addressing concerns on behalf of patients and families working in tandem with the hospital administrator. They are responsible for gathering data regarding patient care issues and inquiries, assessing patient well-being, suggesting improvements, and interpreting hospital service, policies, and procedures to patients and families. Patient Liaisons also work to educate health care professionals in humanizing the hospital experience for patients. They work in a hospital, clinic, nursing home, or programs related to public health.
The required skills of the two careers differ considerably. For example, patient representatives are more likely to have skills like "check-in," "patient care," "telephone calls," and "strong customer service." But a patient liaison is more likely to have skills like "health system," "surgery," "social work," and "employee engagement."
Patient liaisons make a very good living in the health care industry with an average annual salary of $32,280. On the other hand, patient representatives are paid the highest salary in the non profits industry, with average annual pay of $34,572.When it comes to education, patient liaisons tend to earn similar degree levels compared to patient representatives. In fact, they're 2.5% more likely to earn a Master's Degree, and 0.4% more likely to graduate with a Doctoral Degree.Patient representative vs. Patient service specialist
A patient service representative serves as a patient's primary point of contact in a hospital or clinic, ensuring accuracy and customer satisfaction. They are mainly responsible for gathering a patient's information and medical history, verifying insurance forms, managing accounts, and processing payments, arranging appointments, and even performing reminder calls and correspondence. There are also instances when a patient service representative must discuss situations to patients and their families, and even alert the doctors when a patient displays strange or unlikely behavior.
Types of patient representative
Updated January 8, 2025
