Patient Service Representative

Job Description

ST. CHARLES HEALTH SYSTEM                                                                    

JOB DESCRIPTION                                                                                                                                         

TITLE:                                      Patient Service Representative 2

REPORTS TO POSITION:         Clinic Supervisor/Manager

DEPARTMENT:                         St. Charles Medical Group

DATE LAST REVIEWED:          November 2024

OUR VISION:                Creating America’s healthiest community, together

OUR MISSION:             In the spirit of love and compassion, better health, better care, better value

OUR VALUES:              Accountability, Caring and Teamwork

DEPARTMENTAL SUMMARY: The Patient Service Representative (PSR) position is staffed throughout all St Charles Health System ambulatory outpatient service lines and specialties, located throughout the Central Oregon tri-county area. 

POSITION OVERVIEW: The Patient Service Representative 2 is an advanced patient services position and acts as liaison between patients and the professional staff by facilitating clerical and reception responsibilities and assisting in administrative tasks.  PSRs collaborate with clinical staff to ensure we are providing our community with comprehensive and compassionate health care.

This position does not directly manage any other caregivers, however, may be asked to review and provide feedback or training regarding the work of others.

ESSENTIAL FUNCTIONS AND DUTIES:

Patient Scheduling

• Accurately schedules appointments based on department scheduling guidelines, maximizing patient access and provider utilization.

• Performs advanced and complex scheduling functions for the department. 

• Maintains advanced scheduling knowledge to perform additional scheduling functions including but not limited to cancelling, rescheduling and no showing appointments in accordance with SCHS policy and procedure. 

• Uses electronic health system to maintain department appointment requests, waitlist and follow up reports.

Pre-Arrival and Financial Clearance

• Performs real time eligibility (RTE) for insurance benefits.

• Uses RTE information to accurately route scheduling requests or schedule appointments. 

• Ensures authorization is linked to all appointments at the time of check in.

• Assists with processing of authorizations and / or referrals with medical staff as required by insurance companies.  Explains authorization requirements and answers patient authorization questions.    

• Reconciles daily schedules with appointment reports.

• Responsible for addressing registration related work queue items that require resolution prior to encounter closure. 

Patient Registration

• Responsible for accurately recording patient demographics, insurance and billing information at the time of scheduling, check in, and check out.

• Courteously and confidently requests appropriate patient payments from patients/guardians.  Accurately process all payment types (copays, co-insurance, prepayment, deductible, self-pay balances) and completes daily deposits and batch reports.

• Resolves complex registration errors and missing registration items. 

• Consistently meets or exceeds point of service cash collection expectations.

• At the time of check out, provides patient with printed After Visit Summary upon request, schedules follow up visits as needed, collects any copay that remains due for the day’s services.    

• Performs more complex patient status and ancillary registration functions within the EHR.  Examples include but are not limited to chart correction requests, deceased patient worklow, and mark patients for merge. 

Clinic Daily Operations

• Maintains patient access related departmental files, programs and lists.

• Uses EHR to generate patient lists and letters.  Route letters for printing and via patient portal.

• Performs maintenance of department downtime processes and documentation. Assists department leaders and can serve as a subject matter expert in the event of a downtime.    

• Performs daily readiness activities such as turning on computers, equipment, kiosks, readying patient waiting are