Patient Service Representative - Orthopedics

Patient Service Representative - Orthopedics

Northern Light Mercy Hospital | US:ME:Falmouth | Administrative Support | Full Time

Position is located: 20 Northbrook Drive

Work Type: Full Time

Hours Per Week: 40.00

Work Schedule: Variable

Description

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.

Competencies and Skills

• 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.

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.