Overview

Primary Accountability

 

Provides administrative support to ensure patients are welcomed to the organization, scheduled and registered for services in various departments within the organization. Responsible for supporting Medical, Dental, Eye Care, Call Center, or Patient Benefit teams in the efficient processing of patients and the successful application of fiscal procedures.

 

Responsibilities

Description of Primary Responsibilities

Patient Services Representative (Medical/Dental/Eye Care/Call Center/Patient Benefits):

Responsible for scheduling appointments, welcoming patients, registering and supporting patients until patient is seen for their scheduled services.

Responsible to pre-register patients which includes verification of insurance coverage, creating and assigning cases as needed, and confirmation that appointment meets scheduling protocols.

Responsible to ensure completion of all necessary medical, dental, optical and Patient Benefit forms utilizing electronic or paper.

Responsible to collect patient co-payment/co-insurance at time of service or initiate payment plan according to company protocol.

Responsible to ensure patient emergencies are immediately communicated to clinical staff.

Responsible to drive quality initiatives to improve preventative care across the organization.

Responsible to assist patients in selecting a Managed Care Plan and/or Primary Care Provider.

Responsible to assist patients with completing Labor and Industries forms.

Responsible for the proper handling of company property per protocols and manufacturer and health and safety recommendations.

Responsible to complete no-show call-backs on a daily basis to promote the company’s policies and educate on alternative support services.

Responsible to handle basic medical records requests.

Responsible to ensure patient waiting areas are presentable and managed according to company standards.

Responsible to promote a positive work culture and upholds clinic policies and procedures, including the WE CARE standards of Behavior.

Responsible to uphold confidentiality at all times in regards to CBHA activities, reports, financials, patient health information and other proprietary information specific to CBHA.

Other duties as assigned

 

Specific area responsibilities as assigned:

 

Dental

Responsible for dental prior-authorizations.

Responsible to completes prior-authorizations for dental procedures and submits x-rays.

Responsible for transferring medical records to other providers or to ensure referrals are completed.

Responsible to provide follow-up with patients after response from insurance company.

Responsible to sets up patients with orthodontic payment booklets and ensures timely payments are made prior to scheduling next month’s services.

Responsible to ensure orthodontic charts are available and up-to-date at time of service

Responsible for the coordination of pediatric dental surgery schedules, pre-op medical clearances and other needed documentation to ensure pre-procedure compliance to company protocols, as assigned.

Travel to multiple school and community locations as assigned, sometimes requiring early start times or schedule flexibility.

Interact professionally and compassionately with children of various ages during dental screening activities.

Communicate effectively with school nurses, teachers, and administrative staff to coordinate screening schedules and logistics.

Prepare, organize, and transport screening materials and supplies to school and community sites.

Ensure proper consent, documentation, and confidentiality requirements are followed.

 

Call Center:

Responsible to identify and transfer incoming calls for all CBHA sites to the appropriate department including sending necessary communication to provider teams via phone notes through the medical records system.

 

Description of Primary Attributes

 

General Development:

Ability to work with confidential information.

Ability to multi-task with high degree of accuracy and organization.

Demonstrates great customer service skills and ability to communicate professionally with patients, specialty clinics, and vendors.

Possesses skills in motivation, self-direction and punctuality.

Ability to work well as part of a team and keep team members updated on current project developments.

Models excellent customer service:

Provides exemplary customer service

Promotes utilization and standardization of AIDET model

Supports