Patient Service Representative (47268)

CFH is looking for PSRs for our Manhattan location. 

SUMMARY: The Patient Services Representative (PSR) provides day-to-day front/back-end support to patients and the clinical team under FQHC Article 28 and the Patient-Centered Medical Home (PCMH) model. The PSR will obtain and verify patient demographic, insurance, and income information to ensure accurate and timely visit processing and reimbursement. The PSR will also check patients in and out of their face-to-face or telemedicine visits, schedule follow-up appointments, and process referrals and authorizations. The PSR will work as part of our PCMH team. with the following essential duties and responsibilities:

ESSENTIAL DUTIES AND RESPONSIBILITIES OF A PATIENT SERVICES REPRESENTATIVE:

• Collaborate with clinical and administrative teams to ensure patients receive patient-centered quality health care.
• Provide clerical and administrative support to patients and Practitioners; support may occur in-person, via telephone, fax, or patient portal (web-encounters).
• Greet patients and visitors, take and relay messages to the patient’s care team, liaise between patients, CFH, and off-site service providers such as specialty and radiology providers.
• Participate in process improvement committees, training, and staff meetings, as needed

Patient Registration, Documents, and Insurance Verification

• Register new patients to their preferred CFH site and/or update existing patient accounts.
• Ensure the patient completes all patient forms, including but not limited to registration forms, sliding fee scale self-declaration and acknowledgment, consents for treatment, Health Insurance Portability and Accountability Act (HIPAA) form, and Advanced Directives.
• Obtain and scan copies of patient documents including but not limited to photo identification card(s), insurance card(s), referrals, consults, and emergency room discharge summaries.
• Accurately input/update patient demographic information to eCW, including, but not limited to patient’s name, birth date, address, telephone, email, insurance (medical, dental, vision), income and family size, housing status, veteran status and sexual orientation/gender identity.
• Web-enable all patients for access to their patient portal, as per CFH policy.
• Screen all patients (insured, uninsured, underinsured) for the sliding fee scale, and update patient income and family size in eCW to reflect the appropriate sliding fee scale.
• Collect payments, co-payments or sliding fees under CFH policy.
• Waive the collection of payments, co-payments or sliding fee, as needed, following CFH policy.
• Refer all uninsured or underinsured patients to CFH Certified Application Counselors (CAC) to be screened for insurance eligibility.
• Verify patient’s medical, dental or visit insurance(s) to ensure coverage is active on the date of services, including but not limited to Medicaid, Medicaid Managed Care, Medicare, Medicare Managed Care, and Private or Commercial plans.
• Utilize insurance eligibility/verification portals to retrieve accurate patient insurance information, including but not limited to, ClaimRemedi, ePACES, eviCore, Managed Care and/or Private/Commercial individual portals.
• Add, modify or update the patient’s medical, dental and vision insurance information to eCW.
• Ensure the appropriate medical, dental, and vision insurance is associated with the patient’s visit on the date of service.
• Assist patients with assigning their Managed Care plan’s Primary Care Provider (PCP) to CFH provider, as needed.
• Assist patients with assigning their Managed Care plan’s Dental Provider to CFH provider, as needed.
• Check-in patients to their face-to-face or telemedicine visits upon verification of all mandatory patient fields, insurance(s), and sliding fee scale.

Appointment Scheduling

• Manage requests for new, follow-up, routine care, offsite specialist or radiology appointments as requested by the Practitioner or patient; requests may be received in-person, via telephone, fax, or patient portal.
• Reschedule appointments as requested by the Practitioner or patient.
• Update the appointment visit status to reflect the appropriate stage of the patient v