The posting
Job Description
At Northbay Health, the Patient Services Representative III is responsible for scheduling surgeries and referrals, in coordination with the care team. They also promptly assist patients with their financial clearance prior to, during, or after their treatment period. This position is responsible for obtaining and updating insurance, financial, and demographic information. Courteously and professionally helps patients and/or their families understand and assist with options to cover their financial obligations including but not limited to: co-pays, deductibles, and co-insurance. Responsible for establishing payment plans and collecting true self-pay and self-pay residual balances as necessary. Responsible for assisting patients with ad-hoc financial issues as needed prior to, during and following their treatment.
Offers financial advice and assistance to patients regarding medical bills. They are the liaison between patients and their insurance companies; often coordinating payments and answering questions from both parties. Their job is to handle financial obligations so that patients and physicians can focus on healthcare.
Primary Job Duties
- May provide cost estimates for outpatient and inpatient care.
- Educate patients about payment options and financial assistance.
- Negotiates and strategize patient payment arrangements.
- Update patient accounts and balances.
- Review and process patient and insurance company forms.
- Communicate with patients, insurance company, Ambulatory Surgery Center Scheduler, and OR
- Scheduler on the phone.
- Coordinates with surgeons care to in scheduling elective and non-elective surgeries in the Ambulatory Surgery Center & OR.
- Informs and/or updates supervisory personnel of any patient billing concerns.
- Answers all patient billing questions and works with ambulatory accounting or insurance companies to correct patient billing errors.
- Communicates and collaborates with other departments to provide continuity of care across departments and disciplines.
- Assists PSRs with their workload, and gives support as needed.
- Schedules referrals for orthopedic providers in clinic.
- Consistently demonstrates and promotes a sense of team within the immediate and extended work groups, and maintains effective communication with all external and internal customers.
- Works on special projects and/or interdisciplinary committees as assigned.
- Other duties as assigned.
Qualifications
- Education: High School graduate preferred. Associate Degree or Bachelor’s Degree preferred.
- Experience: Minimum of two year’s of experience in a medical front office setting with experience and knowledge of health insurance/ benefit requirements required. Two years’ experience working with medical insurance plans. Two more years’ experience working with referrals/consult processes in the ambulatory care setting.
- Skills: Excellent customer service skills, and comprehensive knowledge & understanding of workflow and processes in the revenue cycle environment. Excellent analytical and project management skills. Ability to work on multiple projects simultaneously and manage deadlines. Must possess good organizational skills, work independently, and prioritize multiple projects and objectives in a rapidly changing environment. Ability to communicate clearly and effectively, relate cordially with co-workers, members, providers and others. Download and save reports in Excel, and sort reports by name, date or in descending dollar order, when taking calls from patients, providers or payers, the representative needs the ability to determine the necessary action to take, such as the appropriate questions to ask, or determining the research necessary to answer questions. Knowledge of medical terminology, CPT, ICD-10-CM, and Revenue Codes, Medicare guidelines and regulations, billing and follow-up practices, billing requirements for all payer types, managed care terminology (capitation, PPO, stop loss, etc.), Cerner, Microsoft Outlook, Word, and Excel.
- Standards of Performance: Demonstrate performance by adhering to established policies and procedures and exhibiting the defined characteristics associated with attendance and punctuality.
- Physical Effort: Attendance is an essential function of the job. The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Minimal: Requires prolonged hours of standing and sitting and some walking. Requires extensive use of telephone and computer keyboard. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Hours of Work: Based on business need.
About Us
Interpersonal Skills and Values
Demonstrates NorthBay Health’s True North Values: Nurture Care, Own It, Respect Relationships, Build Trust, and Hardwire Excellence. These values guide behavior, accountability, teamwork, and commitment to high-quality patient care.
Why NorthBay Health
NorthBay Health is an independent, nonprofit health system serving the Napa, Solano, and Yolo County regions. We are expanding access to care across our communities through two acute-care hospitals, including a Level II Trauma Center and a Level III NICU maternity unit, along with a cancer center, urgent care locations, and a growing network of primary and specialty care clinics.
We provide advanced services in cardiovascular care, neuroscience, orthopedics, surgery, and outpatient specialties. NorthBay Health is nationally recognized for quality care, including Magnet with Distinction designation for nursing and multiple U.S. News and World Report high performing recognitions.
We are committed to being the trusted healthcare partner of choice and offer an environment where employees can grow, contribute meaningfully, and support the health of our communities.
NorthBay Health Benefits Options
NorthBay Health offers a comprehensive benefits package based on established eligibility requirements. Benefits may include medical, dental, and vision insurance, life, disability, and long-term care coverage, paid time off including vacation, sick leave, holidays, and bereavement, a 403(b) retirement plan with employer match, education reimbursement for eligible roles, professional development and training programs, Employee Assistance Program, wellness programs, recognition programs, shift differentials, and market-based compensation review and increases subject to approval and organizational performance.
Compensation Structure
NorthBay Health uses a structured compensation framework. Staff-level positions use a step-based system (Steps 1–5) based on years of directly related experience, with Step 5 representing 20 or more years of experience in the role. Manager level and above positions are paid a fixed annual base salary and are eligible for a variable incentive compensation plan. Physician compensation is structured based on specialty and role requirements.
Remote Work Disclosure
NorthBay Health is primarily an onsite organization due to the nature of healthcare. Some roles may allow hybrid or remote work based on business needs.
Remote work is not supported in Washington, Ohio, Wyoming, North Dakota, Puerto Rico, the U.S. Virgin Islands, or outside of the United States.
Notice to Recruitment Agencies
NorthBay Health utilizes a managed service provider (MSP) for agency partnerships and is not currently engaging external recruiting firms outside of established agreements. We do not accept unsolicited resumes or third-party candidate submissions. Please do not contact NorthBay Health employees, leaders, physicians, or hiring managers regarding recruitment or job postings.
More Information
Visit NorthBay Health Careers for recruitment FAQs and additional information.
