Patient Services Representative (CC2653 - NIC)

Patient Services Representative

Responsible for answering telephone, making appointments, providing exemplary customer service. Assist with completion of referrals for Family Practice, Pediatric and Behavioral Health providers. Assist with verification of insurance coverage and obtain authorizations if needed. Enters referral and documents communications in Electronic Medical Record system. Maintains appointment system adequate to meet applicable professional, administrative and legal requirements.

DUTIES AND RESPONSIBILITIES:

1. Provides appropriate telephone etiquette established by providing prompt and courteous service upon each telephone call received. Seeks and supports changes in call flow processes and communication services. Suggests improvements and participates in organized efforts to improve service excellence levels.
2. Schedules patient appointments by abiding by the established provider template ensuring the patient information is current and/or updated. Works cohesively and interdepartmentally with providers and support staff to optimize the provider's schedule and performs patient schedule changes as needed. Schedules and relays information with company or organization in healthcare field. Ensure accurate demographic information is entered in NextGen EPM.
3. Informs patients of required documentation necessary for registration, account update or release of patient information. Ensures ongoing tracking provides appropriate documentation on referrals to promote and ensure patient safety. Provides required information to patients of Sliding Fee Scale availability and the required documentation required for program participation.
4. Refers patient telephone calls promptly to the appropriate clinic or clinician nurse if patient voices an immediate need.
5. Transfers complex and/or patient complaint telephone calls to the appropriate Director/Supervisor/Department to ensure patient satisfaction and confidentiality.
6. Provides excellent internal/external customer service via telephone contact to assist patients with their health care needs.
7. Performs other related duties as assigned.

JOB QUALIFICATIONS:

• High School graduate or equivalent required
• Medical background experience preferred
• Minimum of one year of experience in customer service
• Basic computer skills with proficiency in data entry, keyboarding skills
• Bilingual (English/Spanish) preferred
• Scheduled hours and/or work locations are subject to change

PHYSICAL ACTIVITIES AND REQUIREMENTS:

• Finger Dexterity: Using fingers to make small movements such as typing or picking up small objects.
• Talking: Frequently conveying detailed or important instructions or ideas accurately, clearly, or quickly.
• Hearing: Able to hear average or normal conversations and receive ordinary information.
• Repetitive Motions: Frequently and regularly using the wrists, hands, and fingers.
• Visual: Average, ordinary, visual acuity necessary to prepare or inspect documents or other materials.
• Physical: Physical work involving bending, stooping, standing most of the time. May have to lift folders, files, papers, equipment, and other such items weighing up to approximately 25 lbs.

EDUCATION:

High School/GED or better in General Business.