Patient Service Representative - South Portland Primary Care

Patient Service Representative - South Portland Primary Care

Northern Light Mercy Hospital

Department: Primary Care - South Portland

Position is located: Northern Light Home Care & Hospice So Portland

Work Type: Full Time

Hours Per Week: 40.00

Work Schedule: 8:00 AM to 5:00 PM

Summary: This position is responsible for performing a variety of daily office functions for a multi-physician hospital outpatient practice. This person serves as an ambassador of the organization as they act as the liaison between the practice and its patients, visitors, and guests; the incumbent should consistently display a high level of customer service. The incumbent may have access to highly confidential patient, employee and/or Organizational proprietary information, and must handle and protect the information in accordance with hospital and system policies, HIPAA requirements and the highest level of ethical standards. The incumbent is responsible for reporting all security events, potential events, or other security risks to the organization. The incumbent is responsible for participation in and completion of all patient safety initiatives appropriate to the position, and conducts all job responsibilities according to the Mission and Values of the Hospital.

Responsibilities:

• Treats all patients and customers in polite, prompt and helpful manner in keeping with Organization Values and Standards
• Active participant in regular huddles and team meetings to improve workflows and contribute to improving patient population outcomes.
• Ability to maintain productivity and efficiency in work flow to accommodate the volume and acuity of the practice
• Demonstrates ability to handle difficult conversations with patients and internal customers.
• Registers all patient demographic and insurance information accurately at the time of appointment, and provides necessary forms for completion in accordance with all insurance regulations and practice policy.
• Provides excellent customer service for incoming inquiries. Screens calls, documents detailed messages and routes to the appropriate individual in a timely manner
• Schedules, reschedules, confirms, acknowledges, and cancels patient appointments including surgical and ancillary service
• Monitors daily schedules, notifying manager or all team members of potential issues or access opportunities
• Collects co pays/patient due balances
• General understanding of insurance plans with a greater detailed knowledge of the most frequently seen insurance plans
• Utilizes insurance verification system and takes appropriate action based on eligibility response
• Obtains patient consents and signatures, schedules follow-up appointments when indicated.
• Performs end of day reconciliation of payments, appointments and validation
• Investigate and problem solve insurance denials on a monthly basis in order to recover lost revenue and to become aware of how to proactively submit clean claim
• Is patient centric in interactions and in decision making
• Participates in the referral process as outlined by Medical Associates
• Initiates, receives, and/or processes insurance and services referrals in compliance with the patient's plan and in conjunction with the Medical Associates referrals protocol
• Proactive in identifying, reporting and participating in the resolution of any potential or actual patient safety issues
• Processes health information requests in accordance with Organization and MMA policy
• Screens and invites patients to the electronic patient portal
• Displays cooperative behavior. Interacts positively and effectively with others to promote a team environment
• Creates, maintains, and pulls patient charts, either physically or electronically, as outlined by the practice.
• Acts as a back-up for coworkers as needed
• Demonstrates and promotes the mission and values of the organization
• Ensures compliance with the hospital, state, and federal regulations
• Works in a way to uphold HIPAA standards, in compliance with the law
• Performs additional duties as required or assigned to maintain the overall efficiency and continuity of the facility.

Other Information :

Competencies and Skills

• Effectively Communicates: Listens, speaks and writes appropriately, using clear language. Communication methods are fitting to the message(s), audience, and situation and follow-ups are regular and timely. Shows that important (non-) verbal information is absorbed and understood and asks further questions to clarify when necessary. Expresses ideas and views clearly to others and has ability to adjust use of language to the audiences' level.
• Provides Patient-Centered Care: Demonstrates understanding of patient care quality and service as organizational priority. Proactively supports change to improve patient experience and results. Exhibits the ability and willingness to find out what the patient wants and needs and to act accordingly, taking the organizational and outside resources into account. Cooperates, collaborates, communicates, and integrates care within and between teams to ensure that care is continuous and reliable.
• Behaves with Integrity and Builds Trust: Acts consistently in line with the core values, commitments and rules of conduct. Leads by example and tells the truth. Does what they say they will, when and how they say they will, or communicates an alternate plan.
• Cultivates Respect: Treats others fairly, embraces and values differences, and contributes to a culture of belonging, empowerment, and cooperation.
• Fosters Accountability: Creates and participates in a work environment where people hold themselves and others accountable for processes, results and behaviors. Takes appropriate ownership not only of successes but also mistakes and works to correct them in a timely manner. Demonstrates understanding that we all work as a team and the quality and timeliness of work impacts everyone involved.
• Practices Compassion: Exhibits genuine care for people and is available and ready to help; displays a deep awareness of and strong willingness to relieve the suffering of others.

Education

• Required High School Diploma/General Educational Development (GED)

Working Conditions

• Potential exposure to abusive and/or aggressive people.
• Potential exposure to diseases or infections.
• Potential exposure to noise levels being uncomfortable.
• Potential exposure to noxious odors.
• Potential exposure to very hot or cold temperatures.
• Work with computers, typing, reading or writing.
• Lifting, moving and loading 20 to 30 pounds.
• Prolonged periods of sitting.

Northern Light Mercy Hospital is a nonprofit acute care hospital in Portland, Maine, and a sponsored ministry of the Sisters of Mercy of the Americas. Our work is grounded in compassion, dignity, and service, with a commitment to caring for every member of our community, especially those most in need. At Mercy, people come to work knowing their role matters. Whether at the bedside, in support services, administration, or clinical care, every team member contributes to a culture built on respect, collaboration, and purpose.

We provide a broad range of medical and surgical services, along with multiple primary and specialty care offerings and community-based programs that extend our impact beyond the hospital walls. As a member of Northern Light Health, an integrated statewide health delivery system, employees benefit from the stability, resource, and career pathways of a larger organization while working in a hospital that feels personal and connected. Team members have opportunities to grow professionally, explore new roles, and build long-term careers in an environment focused on quality, innovation, and the well-being of our workforce.

Mercy Hospital is located in Portland, Maine's largest and most vibrant city, offering an exceptional quality of life that attracts people from across the country. Portland is nationally recognized for its food scene, arts and culture, vibrant neighborhoods, and strong sense of community. Within minutes of the city, you can reach beaches, islands, lakes, and mountain trails, with easy access to hiking, skiing, boating, and cycling. The region also offers excellent schools, family-friendly neighborhoods, and easy travel connections through Portland International Jetport and nearby rail service to Boston. Southern Maine blends career opportunity with a lifestyle centered on balance, outdoor recreation, and coastal living, making it an ideal place to live and build a career.

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Equal Opportunity Employment

We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, age, disability status, gender, sex, sexual orientation, gender identity, ancestry, protected veteran status, national origin, genetic information or any other legally protected status.