Patient Service Representative

Summary: 

In collaboration with the multi-disciplinary care team performs the administrative tasks necessary to support exceptional patient-centered care; such as, reception, registration, demographic and insurance verification, answer telephone calls and direct to the appropriate individual, strong customer service skills among patients and multidisciplinary team. As a level II works independently under the supervision of the Practice Supervisor or Manager.

Job Responsibilities: 

1) Managing the Patient Experience: Greets patients promptly in warm, friendly manner demonstrating appropriate amount of interest or concern. Smile, make eye contact, use welcoming language (hello, welcome, how can I help you today). To maintain patient confidentiality use the system to verify reason for visit. Gather and/or verify patient demographics. Confirm that we have referrals or pre-authorizations if necessary. Give the patient a provider update (on time or running late, etc.). Hospitality: Maintain waiting area, check reading materials, play areas, etc. Direct patient and family members to restrooms and other amenities. Check to see if there is any other way you can assist. Employees at this level are comfortable with a wide diversity of patients their families and caregivers and can address concerns and make recommendations for improving their experience.

2) Insurance Verification: Request proof of insurance; verify using appropriate systems, initiates contact for financial counseling. Assist patients or customers fill out and complete medical release of information accurately. Understands insurance coverage and understands billing for part A (hospital) and part B (provider).

3) Payments: Co-payments- Requests, accepts and documents co-payments and payments on account balances and releases change. Secures cash drawer according to departmental procedures. Prepares daily deposit. Prepares deposit slips and submits with payments. Reconciles collections and billing information. Provides a receipt.

4) Communication: Develops and maintains working relationships with coworkers and providers, other agencies and ancillaries. Receives and provides information as necessary while complying with policies and regulations (e.g. HIPPA). Addresses public in a cheerful customer service focused manner. Demonstrates awareness of cultural differences and adjusts to accommodate differences. Manages difficult conversations.

5) Check out: Following departmental protocol reviews patient information to ensure patient has necessary information, schedule follow-up/next visits, and provide referrals. Time stamp patient out in appropriate system(s). Depart summary is offered to every patient.

6) Telephone: Answers telephones in prompt courteous manner within practice time frames. Routes phone call to appropriate person and/or creates message in system. Works administrative messages and responds or directs calls as appropriate.

7) Appointments: Schedules/creates new, follow-up or walk-in appointments according to practice guidelines. Ensures a duplicate medical record number is not created. Makes reminder calls to patients. Cancels appointments managing wait lists and no shows.

8) Mail Processing/Faxes: Opens, sorts and distributes all incoming mail and faxes daily according to practice guidelines.

9) Documentation: Prints orders, letters, or one or two pages medical records (directs or assists in contacting HIM for larter records), obtaining appropriate releases or approvals in compliance with practice policy and regulations (e.g. HIPPA). Prepares documents for scanning.

10) Schedules: Works physician schedules ensuring patients are seen in accordance with practice guidelines. Works with physicians and practice manager or supervisor to schedule or reschedule appointments to meet patient or practice needs.

11) Leadership: Understands and complies with office procedures and policies. Makes recommendation for changes to improve quality, efficiency or patient experience.

12) Interpreter Services: If approved, provides interpreter services for nurses, providers and social services staff as needed. Accurately interprets questions, information and instructions for patients and providers much of which includes medical terminology. Explain cultural differences to patients and providers to promote understanding and facilitate quality patient care. Translate brief provider instructions for patient/family into target language. Spot translate written documents as necessary to or from target language. Completes one evaluation translation annually.

13) Other Duties-Practice Specific: Responsibilities may be more specialized than as detailed above in larger practices or may include additional duties in