Patient Services Representative

Capital Health Administrative Assistant

Capital Health is the region's leader in providing progressive, quality patient care with significant investments in our exceptional physicians, nurses and staff, as well as advanced technology. Capital Health is a dynamic health care resource accredited by the DNV that includes two hospitals, an outpatient center, satellite ED, and an expansive network of primary and specialty care. Capital Health Medical Group is made up of more than 600 physicians and other providers who offer primary and specialty care, as well as hospital-based services, to patients throughout the region.

Capital Health recognizes that attracting the best talent is key to our strategy and success as an organization. As a result, we aim for flexibility in structuring competitive compensation offers to ensure we can attract the best candidates.

The listed pay range or pay rate reflects compensation for a full-time equivalent (1.0 FTE) position. Actual compensation may differ depending on assigned hours and position status (e.g., part-time).

$17.00 - $20.85

Scheduled Weekly Hours: 40

Position Overview

• Answers telephones promptly and courteously, while handling multiple phone lines. Routes patient calls efficiently and appropriately to appropriate area/individual.
• Schedules and cancel's appointments using established office guidelines; Schedules patients for outpatient tests and surgeries according to CH policy.
• Prepares for day, reviews eligibility and phone reports, and carries out tasks accordingly; prepares new patient charts and/or paperwork at patient presentation.
• Greets all patients and visitors in a professional and welcoming manner. Informs patient of privacy policies and procedures; Informs patients of delay's in physician schedules, assists with patient comfort while delayed.
• Performs registration to ensure demographic and insurance information is accurate and complete. Complies with department procedures and regulatory guidelines for HIPAA, Advance Beneficiary Notice, Advance Directives, and Patients Rights as measured by Q/A and observation. Ensures all requirements and fields noted on check-in and check-out page are satisfied and complete.
• Obtains copies of insurance cards, driver's license, authorizations, and referrals; cans or enters into system.
• Collects co-payments and outstanding balances at check-in, and time of service balances and estimated balances at check-out according to policy.
• Refers patients to CBO staff regarding past due balances, questions and/or resolution.
• Reviews and complies with Patient Account Notes and Appointment Notes in system; Accepts accountability for all Worklists/Boxes on dashboard or elsewhere based on assignment.
• Confirms charges / approves claim creations in system at Check-Out; Validates and submits appropriate claims for real time adjudication; Works "Day End Review" report and designated Tier-based HOLD Claim Worklists on a daily basis.
• Schedules follow-up appointments, creates appointment ticklers in system, and works associated Worklists/boxes relative to both based on assignment.
• Completes referrals and pre-authorizations as required.
• Creates a Time of Service batch and links it to a deposit batch daily; Reconciles, balances, and closes each batch /drawer at end of day; Turns over batches to designated resource daily.
• Performs clerical duties including, but not limited to processing mail, confirming appointments, sending out follow-up notices, and maintaining statistics.
• Performs other duties as assigned and may be assigned to other Capital Health Medical Group Practices as needed.

Minimum Requirements

• Education: High School diploma or equivalent.
• Experience: One year experience as receptionist or clerk in healthcare environment or one year customer service experience.
• Knowledge and Skills: Familiarity with medical terminology, ICD-10 and CPT codes. Excellent communication and interpersonal skills. Medical assistant or medical office technician certification preferred.
• Special Training: Proficient computer skills; basic Microsoft office skills. Familiarity with excel spreadsheets.
• Usual Work Day: 8 Hours

Physical Demands and Work Environment

• Frequent physical demands include: Sitting
• Occasional physical demands include: Standing, Walking, Climbing (e.g., stairs or ladders), Carry objects, Push/Pull, Twisting, Bending, Reaching forward, Reaching overhead, Squat/kneel/crawl, Wrist position deviation, Pinching/fine motor activities, Keyboard use/repetitive motion
• Continuous physical demands include: Talk or Hear
• Lifting Floor to Waist 15 lbs. Lifting Waist Level and Above 10 lbs.
• Sensory Requirements include: Accurate Near Vision, Accurate Far Vision, Moderate Depth Perception, Accurate Hearing
• Anticipated Occupational Exposure Risks Include the following: Bloodborne Pathogens, Chemical, Airborne Communicable Disease, Dust/Particulate Matter

This position is eligible for the following benefits:

• Medical Plan
• Prescription drug coverage & In-House Employee Pharmacy
• Dental Plan
• Vision Plan
• Flexible Spending Account (FSA)
• Retirement Savings and Investment Plan
• Basic Group Term Life and Accidental Death & Dismemberment (AD&D) Insurance
• Supplemental Group Term Life & Accidental Death & Dismemberment Insurance
• Disability Benefits Long Term Disability (LTD)
• Disability Benefits Short Term Disability (STD)
• Employee Assistance Program
• Commuter Transit
• Commuter Parking
• Supplemental Life Insurance
• Voluntary Life Spouse
• Voluntary Life Employee
• Voluntary Life Child
• Voluntary Legal Services
• Voluntary Accident, Critical Illness and Hospital Indemnity Insurance
• Voluntary Identity Theft Insurance
• Voluntary Pet Insurance
• Paid Time-Off Program