Patient Services Representative

Patient Services Representative SY

Indian Health Council, Inc. (IHC) has provided high-quality, compassionate healthcare and support services to the nine Federally recognized American Indian tribes in north San Diego County since 1970. With more than 200 employees serving 2 clinic sites, IHC is proud of the diversity of its staff as a reflection of the community it serves. The reward of working at IHC is more than a paycheck and excellent benefits; it is the impact and contribution to the Tribal community that employees value most. If you are passionate about improving the overall health and wellness of our tribal community, IHC is looking for people like you.

IHC believes in empowering our patients with knowledge to achieve their healthcare goals. We strive to treat the whole person using a multifaceted approach to include physical, mental, emotional, and spiritual aspects of health and wellbeing.

IHC offers PPO medical, dental, and vision insurance with low employee contribution; company-paid life and disability insurance; malpractice coverage for providers; 403B retirement with company matching; generous PTO and Sick time; 14 paid holidays; paid jury service; and paid bereavement leave; reimbursement for professional license(s), and certifications such as CPR and continuing education units. Our facility also qualifies as a high-need area for provider CA State and Federal Loan Repayment Programs.

Serves as the sole contact for greeting and assisting patients and visitors entering the Santa Ysabel Satellite Clinic. Has a high degree of knowledge in the overall PSR field and recognized expertise in specific areas (Medical, Dental, BHD); problem-solving frequently requires analysis of unique issues/problems without precedent and/or structure. May lead programs that include formulating strategies and administering policies, processes, and resources, functions with a high degree of autonomy.

Perform all essential functions of a standard PSR.

Ensure SY front desk processes are carried out in accordance with established protocols and mimics workflow established at main clinic.

Demonstrate the importance of service excellence and interact with patients and customers in a caring and attentive manner; take the initiative to maintain open communication with the customer; provide a positive first experience.

Monitor the efficiency and effectiveness of business operation processes; identify system and workflow deficiencies. Make recommendations for change to the Patient Services Representative Manager as necessary to maintain optimal site performance.

Accurately explain established rules and regulations to patients and the public regarding eligibility criteria for accessing IHC services.

Establish and maintain effective working relationships with other IHC departments and personnel; actively engage with personnel to ensure seamless patient experiences from check-in to check-out.

Engage and support business operations cross-training initiatives; responsible for providing instruction to Rincon site PSR personnel on Santa Ysabel operations.

Direct patient complaints to the appropriate person/system, initiate incident reports and call established codes as so driven by specific events/situations.

Work closely with the Patient Services Representative Manager to assess coverage needs and daily workload requirements of the desk.

Distribute patient registration packets to patients and collect and review intake forms for completeness and accuracy (i.e., consent form, patient registration, screening forms, etc.). Assist patients with completing forms and forwarding to the appropriate personnel and/or scans into NextGen; ROI, Consent to Treatment, Consent to Accompany Minor, and other registration related documents.

Schedule patient medical, dental, and behavioral health appointments and resolve scheduling conflicts. Notify patients of changes/cancellations and prioritize urgency of appointments for rescheduling. Assist with directing and monitoring patient flow.

Conduct patient check-out and ensure appropriate follow-up appointments are scheduled according to check-out template notes.

Review patient screening data with patients to provide further assistance with Insurance applications. (CHDP, Medi-Cal Exemptions Forms, Family PACT, etc.)

Review patient charts for completeness and accuracy, confirm patient insurance eligibility and/or benefits, accurately perform sequencing of insurances.

Perform billing functions as assigned including but not limited to verifying insurance & copayments, generating patient statements, payment posting and collections; informs patients of their financial responsibility upon check-in. Responsible for overseeing Santa Ysabel desk cash box and balances daily at the end of each shift.

Direct medication requests to the appropriate system.

Distribute refill prescription medication to patients.

Handle cash and accurately perform collection of co-payments/payments for prescription medications.

Oversee and conduct completion of prescription tracking log; verify patient information prior to distributing medications.

Review dental treatment plan with patient and obtain signature in coordination with Rincon Billing department staff.

Ensure compliance with HIPAA regulations.

Maintain patient files including but not limited to the scanning and indexing of documents; indexes confidential consent forms into appropriate system categories as received from SY clinical staff.

Responsible for the timely and correct insertion of such documents into patient charts.

Process all requests for Release of Information via walk in, fax and/or legal services. All subpoena duces tecum are to be given to the HIM Manager for review.

Responsible for completing a PHI Disclosure in EHR for all outside facility PHI requests.

Check daily appointment list and retrieve necessary reports/documents from outside facilities needed for the continuity of care, hospital follow-ups, labs, etc.

Process same day urgent and same day patient/provider requests for outside medical records; scans & indexes into appropriate EHR category.

This position has no supervisory responsibilities.

Travel is not required for this position.

Driving is not required for this position.

High school diploma or general education degree (GED) required.

Certificate in Medical or Dental Front Office program preferred.

Must have a minimum of 2 years of patient services representative experience in dental and/or medical offices.

Knowledge of medical and dental scheduling processes and terminology.

Ability to establish and maintain effective working relationships with the staff, public and patients.

Ability to facilitate and coordinate communication between patients, family members and clinical staff.

Ability to multitask and work independently.

Ability to interpret, adapt, and apply appropriate written guidelines and work practices.

Productivity Software: Microsoft Office 365; Word, Excel, PowerPoint, Email & Calendar Management (outlook), Teams (video conferencing and meetings), and Share Point.

Electronic health records software (EPIC MyChart/QSI preferred).

Utilization of Paycom, Relias Learning, and PolicyTech systems.

Current AED CPR certification or attainment within 6 months of hire.

Applicants must successfully pass a pre-employment physical exam, tuberculin skin test or x-ray and urine drug screen test.

Health must be adequate to perform all duties of the position.

Must pass criminal background check.

Indoor office environment.

While performing the duties of this job, the employee is regularly required to sit, use hands to finger, handle, or feel; reach with hands and arms; and talk or hear. The employee frequently is required to sit. Specific vision abilities required by this job include close vision, peripheral vision, and the ability to adjust focus.

Respond promptly and with caring actions to patients and employees.

Maintain professional working relationships with all levels of staff, patients, and the public.

Be part of a team and cooperate in accomplishing department/organizational goals and objectives.

Display knowledge of normal signs of human development and ability to assess and provide age-appropriate care.

Contribute to the success of the organization by participating in quality improvement activities.

Maintain current knowledge of policies and procedures as they relate to safe work practices.

Follow all safety procedures and report unsafe conditions.

Use appropriate body mechanics to ensure an injury free environment.

Follow all infection control procedures including blood-borne pathogen protocols.

Maintain privacy of all patient, employee, and volunteer information. Access such information only on a need-to-know basis and for business purposes only.

Comply with all regulations regarding corporate integrity and security obligations.

Report unethical, fraudulent, or unlawful behavior or activity.

Indian Preference shall be given in accordance with IHC's Policies and Procedures.