Lead Patient Support Representative

Job Description

Job Description

Description:

JOB SUMMARY

Responsible for guiding the front office team to ensure positive business outcomes. Duties include focusing on the constant improvement and maintenance of customer service, process efficiency and effectiveness, lowering error rates, improving TOS payments, and establishing and maintaining daily protocols.

KEY ACCOUNTABILITIES

• Coordinate and manage the activities of front office team members engaged in checking in patients and performing general administrative tasks as directed.
• Monitor daily performance of front office team members ensuring that all check-in protocols are followed by every team member all the time, ensuring patient ID, all demographics are updated and insurance cards are asked for at every visit and entered correctly. The only acceptable goal is 100% verification of all insurances and coverage prior to the patient setting foot in the practice and is entered correctly in the system.
• Hold daily huddles to assist with prepping for the next day schedule by looking at patient’s accounts for balances, copays, problems with insurance and demographics.
• Ensure co-pays and any balances due are paid at TOS while checking the patient in, and providing patients with a receipt of payment. If no copay is received a “Billing Alert” comment needs to be added as to why.
• Notify the billing department regarding patients who have outstanding balances, financial questions, questions regarding their account, and questions about payment plans.
• Prepare payment plans for patients at time of service and notify billing department.
• Monitor Family Planning Medicaid and ensure the waiver is being signed at every visit if it is not related to family planning.
• Meets reasonable benchmarks set by Revenue Cycle Manager regarding the error rate found with patient demographics and insurance.
• Meet with the Revenue Cycle Manager monthly and relay pertinent information to front office team members timely.
• Answering, screening, prioritizing and delegating telephone inquiries in a friendly, professional manner, including using de-escalation skills for disgruntled patients, providers and third parties
• Returning patient, provider and third party calls in a timely manner
• Referring patient inquiries of a clinical nature to the appropriate clinical staff for triage
• Scheduling appointments in accordance with AMCHC guidelines relating to new patient, routine follow-up and same-day appointments
• Checking patients in and out, which includes collecting and entering or verifying patient demographic information such as insurance and/or sliding fee discounts at each appointment
• Scanning and organizing patient documents in the Practice Management (PM) system or Electronic Health Record (EHR) as appropriate
• Assessing patient eligibility for the sliding fee discount program (SFDP) and clearly communicating responsibilities of the patient as part of the SFDP (e.g. providing documentation of income)
• Assessing charges, including past due balances and collection of fees (e.g. co-payment, co-insurance, point-of-care incentive)
• Referring patients with questions regarding billing statements to AMCHC's revenue cycle vendor
• Assessing accuracy and completeness of medical record requests from patients, providers and third parties, scanning requests into the EHR and assigning requests to AMCHC's medical records vendor
• Providing AMCHC organizational information such as location of practices, hours of operation, insurance participation and SFDP to patients, providers and third parties
• Actively participating in and supporting quality improvement practices.
• Maintaining confidentiality and complying with all aspects of the Health Insurance Portability and Accountability Act (HIPAA)
• Making reminder calls for next-day appointments and informing patients to bring any necessary items, including photo identification, co-payment and current medications
• Assisting clinical staff with patient referrals for specialty care
• As appropriate based on skill set, providing language interpretation to patients appropriate to the front desk role and translating written and web-based documents
• As appropriate based on education and skill set, assisting the clinical team as a Medical Assistant

EDUCATION/EXPERIENCE

High school diploma or General Educational Development (GED)

PREFERRED QUALIFICATIONS

Experience working with racially and ethnically diverse populations, low-income populations and people experiencing homelessness

• At least one year of experience in a primary care or public health setting functioning at the full extent of her/his training
• Experience with Practice Management systems and EHR

KNOWLEDGE, SKILLS & ABILITIES

Knowledge:

• Effective communication
• Superior Customer Service
• Ability to juggle multiple tasks at once and effectively prioritize
• Ability to work harmoniously in a team environment
• Attention to detail
• Full knowledge of Key accountabilities

Skills:

• Exceptional written and verbal communication skills.
• Proficient with medical office technology and equipment, including computers, copiers, scanners, fax machines, and phone systems, as well as MS Excel/Word/Outlook, Electronic Health Record systems and automated medical scheduling and billing programs.
• Excellent interpersonal skills in group and community settings
• Ability to plan, schedule and coordinate
• Effective management of multiple duties and responsibilities in a clinical setting
• Sound leadership and clinical judgment
• Excellent communication skills in person, on the phone and in written communications
• Demonstrating flexibility in providing adequate front office coverage for AMCHC during unexpected absences, events or call volume
• Working collaboratively with staff and management in a team-based environment
• Flexibility in a rapidly growing and changing work environment
• Strong attention to detail
• Exceptional customer service skills
• Ability to maintain confidentiality of financial and clinical information
• Excellent listener
• Demonstrates initiative

PHYSICAL REQUIREMENTS

• Seeing: Must be able to read head written and printed material, as well as use computer, fax machine, Xerox machine and other medical equipment in accordance with specialty.
• Hearing: Must be able to hear well enough to communicate with coworkers and others. Good hearing is necessary to receive detailed information through oral communication and to make fine discriminations in sound.
• Sitting: Must be able to sit for the majority of the work shift while answering telephone and communicating with others.
• Standing/Walking/Mobility: Must be able to stand intermittently and be capable of walking on hardwood and linoleum floors with concrete underpayments. Must be able to walk between various clinical areas and departments.
• Fingering/Grasping/Feeling: This position requires manual and finger dexterity and eye-hand coordination for easy and skillful use of hands when working with and performing normal office duties and responsibilities.

WORK ENVIRONMENT

• Fast paced work environment.
• The noise level in the work environment is usually moderate.