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.

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Patient Representative Responsibilities

Here are examples of responsibilities from real patient representative resumes representing typical tasks they are likely to perform in their roles.

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 Job Description

Perhaps the hardest question to answer when deciding on a career as a patient representative is "should I become a patient representative?" You might find this info to be helpful. When compared to other jobs, patient representative careers are projected to have a growth rate described as "decline" at -2% from 2018 through 2028. This is in accordance with the Bureau of Labor Statistics. What's more, is that the projected number of opportunities that are predicted to become available for a patient representative by 2028 is -51,600.

Patient representatives average about $15.61 an hour, which makes the patient representative annual salary $32,469. Additionally, patient representatives are known to earn anywhere from $26,000 to $39,000 a year. This means that the top-earning patient representatives make $17,000 more than the lowest earning ones.

As is the case with most jobs, it takes work to become a patient representative. Sometimes people change their minds about their career after working in the profession. That's why we looked into some other professions that might help you find your next opportunity. These professions include a medical receptionist, patient care specialist, patient liaison, and patient service specialist.

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12 Patient Representative Resume Examples

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Betty Reed Patient Representative Contact Information Boston, MA (540) 555-5792 breed@example.com Skills Insurance Companies Medical Records Market Surveys Necessary Information Optional Equipment Customer Service Patient Access Renewal Process Office Tasks Lease Agreements Employment History Patient Representative 2018 - Present Children's Hospital Boston, MA Answer, screen and route telephone calls. Managed all medical records, correspondence, EOB's and claim tracer, and patient's inquiry. Post credit card payments * File patient medical records. Worked closely with staff assuring that necessary documentation required by insurance companies was completed and faxed. Clinic Receptionist 2016 - 2018 Equity Residential Boston, MA Charge RN for 8-10 field nurses, coordinating patient care, OASIS proofing, some coding, ran bi-weekly IDT meeting. Assisted all associates in meeting their real estate needs by answering inquiries and scheduling appointments for prospective buyers. Interacted with healthcare members to meet immediate and specific patient care needs. Perform meeting room and conference room set ups. Facilitate patient and clinician communication to promote high quality healthcare and satisfaction for patients. Leasing Consultant 2012 - 2015 Equity Residential Boston, MA Collaborated with property management team to complete monthly financial and property activity reports. Organized and reviewed all documents required for the rental application process and the execution process of lease agreements. Analyzed community market conditions to anticipate market changes or trends that could affect profitability. Education Master's Degree Business 2015 - 2016 Northeastern University Boston, MA Bachelor's Degree Business 2009 - 2012 Northeastern University Boston, MA


Olivia Davis Patient Representative Contact Info Atlanta, GA (430) 555-6156 odavis@example.com Skills HipaaCommunicationPatient CareTest ResultsData EntrySoftware ApplicationsTricareInsurance CompaniesExceeds ExpectationsOperational Areas Employment History Patient Representative 2020 - Present WellStar Health System Atlanta, GA Maintain patient records Processing paperwork for finance and insurance companies. Obtained patient demographic information and entered in the computer system for registration. Adhere to all HIPPA regulations to ensure patients medical records are kept confidential. Medical Administrative Specialist 2018 - 2020 Kaiser Permanente Atlanta, GA Review, process, and distribute dictated reports from Lanier Dictation System to Physicians and hospital chart rooms for patient care. Process claim reviews by contacting patients/members and following procedures with relation to foreign claims. Achieved departmental goals and objectives by instituting new processes and standards for in-patient care. Abstracted pertinent medical information from patient's medical information from patient's medical records and completed disability claim form. Scanned documents and input medical records into the company database. Greet patients in busy emergency room setting. Clerical Associate 2013 - 2018 Mike Anderson's Marion, IN Train and support cast members on lodging operation, system software, and guest service interaction. Obtain required accurate demographic information and signatures of necessary consents in order to register, interview, and admit patients. Answered busy multi-line phones, taking messages and forwarding to the appropriate department. Education Bachelor's Degree Business 2010 - 2013 Indiana Wesleyan University Marion, IN


Rebecca Brown Patient Representative San Francisco, CA (430) 555-6151 rbrown@example.com Experience Patient Representative2020 - Present McKesson•San Francisco, CA Received telephone calls from doctors' offices and processed data and patient information as required. Work closely with Dr. Offices to obtain authorizations, and communicate to all insurance companies to obtain medical benefits. Submit claims to the insurance companies Collected credit card payments from patient to post to patients accounts. Collect outsatnding accounts: Medicaid, Medicare, Blue Sheild and other third party payers. Check Out Clerk2018 - 2020 Vons•Santa Barbara, CA Assist in setting up manufacturers' marketing displays on the sales floors. Assembled orders for customers received on the internet using a hand held computer. Stock merchandise, manage the grocery crew, order merchandise and customer service. Provide friendly and positive customer service to patrons and visitors to the retail stores. Office Secretary2015 - 2018 Santa Barbara City College•Santa Barbara, CA Receive and directing telephone calls and relaying messages to others while maintaining accuracy, clarity and confidentiality. Maintain records and reports updated Make tabulated and, deposits, invoicing and archiving Make and receive phone calls Customer Services Cleared facility issues with Customer Service Orders (i.e. Protected confidential information against any threats or hazards of integrity, unauthorized access, or unauthorized use. Skills Insurance CompaniesSecretarial SupportTelephone CallsGeneral PublicScheduling AppointmentsMedical RecordsOutgoing CorrespondencePayrollPatient ConfidentialityCommunity Members Education Bachelor's Degree Sociology2012 - 2015 University of California, Santa Barbara•Santa Barbara, CA

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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.

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"patients," "check-in," and "medical terminology" aren't the only skills we found patient representatives list on their resumes. In fact, there's a whole list of patient representative responsibilities that we found, including:

Arguably the most important personality trait for a patient representative to have happens to be communication skills. An example from a resume said this about the skill, "customer service representatives must be able to provide clear information in writing, by phone, or in person." Additionally, other resumes have pointed out that patient representatives can use communication skills to "manage high volume patient calls with the patient communication center for all of ucla north west valley clinics. "

Another trait important for fulfilling patient representative duties is computer skills. According to a patient representative resume, "customer service representatives must be adept at using computers. ." Here's an example of how patient representatives are able to utilize computer skills: "scheduled pre-admission testing and completed the patient registration as well as the computer entry of required testing. "

Patient representatives are also known for customer-service skills, which can be critical when it comes to performing their duties. An example of why this skill is important is shown by this snippet that we found in a patient representative resume: "representatives help companies retain customers by professionally answering questions and helping to resolve complaints." We also found this resume example that details how this skill is put to the test: "perform major clerical duties including maintenance of confidential patient charts assist doctors and patients with appointment scheduling multi-level customer assistance"

A thorough review of lots of resumes revealed to us that "interpersonal skills" is important to completing patient representative responsibilities. This resume example shows just one way patient representatives use this skill: "representatives should be able to create positive interactions with customers." Here's an example of how this skill is used from a resume that represents typical patient representative tasks: "trained in and maintained excellent interpersonal and communications skills that complement proven creative problem solving capabilities. "

As part of the patient representative description, you might find that one of the skills that might be helpful to the job is "listening skills." A patient representative resume included this snippet: "representatives must listen carefully to ensure that they understand customers in order to assist them." This skill could be useful in this scenario: "communicated with medical insurance companies for approval. "

While "patience" is listed last on this skills list, don't underestimate its importance to patient representative responsibilities. The skill is described by this resume snippet, "representatives should be patient and polite, especially when interacting with dissatisfied customers." Here is an example of how this skill is used, "exercise of courtesy and patience in speaking with patients, families and others to maintain sound public relations. "

See the full list of patient representative skills.

Before becoming a patient representative, 36.4% earned their bachelor's degree. When it comes down to graduating with a master's degree, 4.7% patient representatives went for the extra education. If you're wanting to pursue this career, it may be possible to be successful with a high school degree. In fact, some patient representatives have a college degree. But about one out of every four patient representatives didn't attend college at all.

The patient representatives who went onto college to earn a more in-depth education generally studied business and health care administration, while a small population of patient representatives studied psychology and nursing.

When you're ready to become a patient representative, you might wonder which companies hire patient representatives. According to our research through patient representative resumes, patient representatives are mostly hired by Children's Hospital Colorado, HealthTrust, and UPMC. Now is a good time to apply as Children's Hospital Colorado has 106 patient representatives job openings, and there are 69 at HealthTrust and 53 at UPMC.

Since salary is important to some patient representatives, it's good to note that they are figured to earn the highest salaries at University of California, Berkeley, University of California, and UC Santa Barbara. If you were to take a closer look at University of California, Berkeley, you'd find that the average patient representative salary is $42,945. Then at University of California, patient representatives receive an average salary of $41,189, while the salary at UC Santa Barbara is $39,840.

View more details on patient representative salaries across the United States.

We also looked into companies who hire patient representatives from the top 100 educational institutions in the U.S. The top three companies that hire the most from these institutions include Aspen Dental, Cedars-Sinai, and University of Miami.

The three companies that hire the most prestigious patient representatives are:

Children's Hospital Colorado106 Patient Representatives Jobs
HealthTrust69 Patient Representatives Jobs
UPMC53 Patient Representatives Jobs

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What Medical Receptionists Do

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.

We looked at the average patient representative annual salary and compared it with the average of a medical receptionist. Generally speaking, medical receptionists receive $509 lower pay than patient representatives per year.

While the salaries between these two careers can be different, they do share some of the same responsibilities. Employees in both patient representatives and medical receptionists positions are skilled in patients, check-in, and medical terminology.

There are some key differences in responsibilities as well. For example, a 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 how truly different these two careers really are.

Medical receptionists really shine in the health care industry with an average salary of $32,483. Whereas 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 is a bit different than that of 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.

What Are The Duties Of a 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.

The next role we're going to look at is the patient care specialist profession. Typically, this position earns a higher pay. In fact, they earn a $1,688 higher salary than patient representatives per year.

While the salary may be different for these job positions, there is one similarity and that's a few of the skills needed to perform certain duties. We used info from lots of resumes to find that both patient representatives and patient care specialists are known to have skills such as "patients," "medical terminology," and "patient care. "

But both careers also use 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," some 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 side of things, patient representatives receive higher paychecks in the non profits industry where they earn an average of $34,572.

When it comes to the differences in education between the two professions, 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.

How a Patient Liaison Compares

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.

Let's now take a look at the patient liaison profession. On average, these workers make lower salaries than patient representatives with a $155 difference per year.

By looking over several patient representatives and patient liaisons resumes, we found that both roles utilize similar skills, such as "patients," "medical terminology," and "insurance verification." But beyond that the careers look very different.

As mentioned, these two careers differ between other skills that are required for performing the work exceedingly well. For example, gathering from patient representatives resumes, they are more likely to have skills like "check-in," "patient care," "telephone calls," and "strong customer service." But a patient liaison might 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. Whereas patient representatives are paid the highest salary in the non profits industry with the average being $34,572.

When it comes to education, patient liaisons tend to earn similar education levels than 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.

Description Of a 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.

The fourth career we look at typically earns higher pay than patient representatives. On average, patient service specialists earn a difference of $1,094 higher per year.

While their salaries may vary, patient representatives and patient service specialists both use similar skills to perform their jobs. Resumes from both professions include skills like "patients," "medical terminology," and "patient care. "

While some skills are shared by these professions, there are some differences to note. "check-in," "customer service," "computer system," and "emr" are skills that have shown up on patient representatives resumes. Additionally, patient service specialist uses skills like patient service, physical therapy, office equipment, and triage on their resumes.

Patient service specialists earn a higher salary in the health care industry with an average of $33,449. Whereas, patient representatives earn the highest salary in the non profits industry.

In general, patient service specialists reach similar levels of education when compared to patient representatives resumes. Patient service specialists are 0.5% less likely to earn their Master's Degree and 0.1% more likely to graduate with a Doctoral Degree.

Updated October 2, 2020