Behavior - Patient Services Rep (Full-Time)

We are an FQHC community health center dedicated to embodying the values central to American Indian cultures. This includes respect for our patients, acknowledgement of the whole person, and a focus on working together to ensure health for the individual, and therefore the community. We invite persons of all tribes, ethnic backgrounds and walks of life to experience the comprehensive care we deliver and to contribute to the services we provide for children, youth, families, adults, and elders.

Summary: This position serves as the Behavioral Health Patient Services Representative for the San Diego Community Health Center Behavioral Health Department. This position ensures that the highest level of patient care is rendered to patients by greeting, answering incoming calls, registration, appointment scheduling, insurance verification and explain financial obligations, updates Eclinical Works(ECW), and Electronic Health Records (EHR) with patient's updates, required administrative forms and documents and performs other various clerical duties

Must be able to demonstrate knowledge and skills necessary to perform all job-related activities as outlined below.

Essential Duties and Responsibilities:

Primary Functions:

1. Greets patients in a courteous and respectful manner and maintains receptionist area and patient lobby clean, safe and comfortable for patients, visitors.
2. Schedule patient appointments including calling patients for reminders the day before, and rescheduling appointments if necessary.

Primary Functions: continue

1. Verifies patient information by interviewing patient; reviewing and/or recording medical history; confirming purpose of visit or treatment.
2. Completes records as assigned by providers. Generate revenues by recording billing information of services rendered; completing insurance forms; responding to insurance and other third-party inquiries.
3. Maintains patient confidentiality and protects operations by keeping patient care information confidential.
4. Assist patients in completing BH client self-assessments and getting release of information forms signed.
5. Ability to handle many phone calls regarding client medication concerns; must be calm and able to handle upset clients in a respectful and factual manner, while also informing PNPs.
6. Obtain insurance "prior authorizations" so patients can be seen and/or medications prescribed.
7. Inventory supplies and materials
8. Data entry to maintain office and patient records.
9. Ability to demonstrate superior customer service.
10. Interact with staff in a supportive manner to keep the workflow going and to keep the department safe and clean.
11. On occasion assist client in office or call in having a crisis and will need to know how to respond to help the client keep calm and to keep the department safe.
12. Ensures verification and data entry of updated demographics and insurance information is completed, clinical and administrative forms and documents are completed and scanned, screens and process applications for available medical programs such as CHDP/EWW/FPACT/SFS, clinical codes are entered correctly during patient check-in.
13. Answers incoming calls and ensures new patient appointments, appointment cancellations and rescheduling of appointments are completed in a timely manner.
14. Ensures voicemail messages and returns phone calls are completed promptly per front desk process and guidelines.
15. Maintains schedules updated with current status throughout the business day, assures no-shows are coded and patients are checked-in and out in a timely manner in accordance with medical department guidelines and process.
16. Ensure the appointment report is scanned to fiscal by 10:00 am the next business day.
17. Identifies patient payer sources, verifies insurance eligibility, and benefits and determines co-pays and deductibles, PCP changes needed, SFS notifications, and communicates to patients and front desk prior to appointment.
18. Ensure scheduled appointments are scheduled within scheduling guidelines.
19. Forwards HEDIS insurance print outs to Provider and communicates any discrepancies to immediate supervisor and provider.
20. Completes administrative check offs by reviewing patient EHR, scheduling system and identifying outstanding required administrative and clinical forms, administrative required documents such as native verifications, photo IDs, insurance cards and completion of SFS applications. Request paper chart from medical records as needed in accordance to medical records policy and guidelines.
21. Ensures data entry of payer source is accurate and updated to coincide with insurance verification, sequence patient's payer sources on the date of service in accordance to billing guidelines.
22. Scans all insurance verification to EHR, edits creation date, and double checks for readability and accuracy.
23. Confirm appointments and documents appointment status in appointment "info box".
24. Provide the front desk with the next day's medical printed schedules prior to the end of the business day.
25. Ensure the provider schedules remain booked by calling patients from the provider "waiting list" and "caseload reports."
26. Other duties as assigned.

Required Qualifications:


To perform this job successfully, an individual must be able to perform each essential duty and responsibilities set forth in this position performance standard policy. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Qualifications:

Minimum Qualifications:

1. High School Diploma or GED (equivalent).
2. Minimum of one year working in a Behavioral Health setting.

Preferred:

1. Experience serving a multinational, multicultural population.
2. FQHC.

1. Familiarity with Community Health Clinics and/or Indian Health Clinics.

1. ECW EHR.

Special Conditions of Employment:

1. CPR/ BLS certification: Maintain a current Basic Life Support (BLS) certification issued by the American Heart Association (AHA), the American Red Cross, or an equivalent organization. Certification must include an in-person, hands-on skills assessment. Online-only certifications are not accepted.
2. Annual background checks: Consent to annual background checks as a condition of continued employment, to ensure compliance with organizational standards and eligibility requirements.
3. For-Cause Drug Screening: Comply with drug screening requirements when initiated by the organization for cause, to support a safe, compliant, and drug-free workplace.
4. Ongoing Compliance Requirements: Maintain up-to-date compliance with all required annual renewals, including professional licenses, certifications, physical examinations, TB testing, and mandatory regulatory trainings as assigned by the San Diego Community Health Center (SDCHC).

Knowledge, Skills and Abilities:

1. Excellent oral and written communication skills.
2. Excellent time management skills
3. Excellent organizational skills and attention to detail.
4. Ability to maintain confidentiality and meticulous records.
5. Effective interpersonal skills.
6. Able to deal effectively with a diversity of individuals.
7. Ability to establish and maintain cooperative working relationships with all during the course of work.
8. Able to perform basic mathematical calculations necessary to perform the job function.
9. Must be reliable and extremely trustworthy.
10. Knowledge of accounting software, database software, internet software, Microsoft Office applications

Physical and Mental Requirements:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job with or without accommodation.

1. Able to lift/move up to 10 pounds, move from place to place.
2. Able to sit at a desk and work on a computer for prolonged periods.
3. Able to stand, bend and reach for prolonged periods.
4. Ability to do math, organize and prioritize workload, work effectively and efficiently under stress.
5. Ability to supervise, multitask, understand, and follow instructions.

Customer Service:

1. Actively supports, promotes, and works to fulfill the Mission, Vision, and core values of SDCHC.
2. Provides excellent internal and external customer service.
3. Demonstrates SDCHC's Standards of Customer Service Behavior: Compassion, Attitude, Communication, Appearance, Sense of Ownership, and Teamwork.
4. Participates in on-going customer service training.
5. In every action, seeks to promote SDCHC as a top service organization.

Quality Management:

1. Contribute to the success of the organization by participating in quality improvement activities.
2. Complies with all SDCHC policies and procedures and proactively participates in the implementation of new initiatives.
3. Participate and ensure continuous quality improvement process as directed by clinic leadership.

Safety:

1. Ensures regulatory compliance and adherence with policies and procedures related to safe work practices.
2. Participate in infection prevention through appropriate use of infection control measures during patient treatment and patient interactions.
3. Ensure compliance with regulatory requirements for maintaining physical spaces, equipment, and supplies.
4. Uses all appropriate equipment and/or tools to ensure workplace safety.
5. Immediately reports unsafe working conditions.

Privacy/Compliance:

1. Maintains privacy and security of all patients, employee, and volunteer information and access to such information. Such information is accessed on a need-to-know basis for business purposes only.
2. Complies with all regulations regarding corporate integrity and security obligations. Reports unethical, fraudulent, or unlawful behavior or activity.
3. Upholds strict ethical standards.

Flexibility: Available for all shifts and, when required, able to work evenings and weekends

Disclaimer

Nothing in this job description restricts management's right to assign or reassign duties and responsibilities to this job at any time. This description reflects managements' assignment of essential functions. It does not prescribe or restrict the tasks that may be assigned. This job description is subject to change at any time.

Preference is given to qualified American Indian/Alaskan Natives in accordance with the American Indian Preference Act (Title 25, U.S. Code Section 472, 473 and 473a). In other than the above, the San Diego Community Health Center, is an equal opportunity employer.

Acknowledgement

San Diego Community Health Center is an Equal Opportunity Employer. We encourage applications from all individuals regardless of race, religion, color, sex, pregnancy, national origin, sexual orientation, gender identity, gender expression, ancestry, age, marital status, physical or mental disability or any other protected class, political affiliation, or belief.

Preference is given to qualified American Indian/Alaskan Natives in accordance with the American Indian Preference Act (Title 25, U.S. Code Section 472, 473 and 473a). In other than the above, the San Diego American Indian Health Center, is an equal opportunity employer.

San Diego American Indian Health Center is an Equal Opportunity Employer. We encourage applications from all individuals regardless of race, religion, color, sex, pregnancy, national origin, sexual orientation, gender identity, gender expression, ancestry, age, marital status, physical or mental disability or any other protected class, political affiliation, or belief.