Patient Services Representative Team Lead

Job Description

Job Description

JOB DESCRIPTION

POSITION TITLE:

Lead Patient Services Representative

POSITION SUMMARY:

The Lead Patient Services Representative works closely with Patient Services Representatives to ensure highest level customer service provided, while maintaining accurate patient records, appointment scheduling, insurance verification, and payment processing systems. This role is a crucial link between CHCFC patients and the care delivered by clinical staff at the health center. The Patient Services Lead is responsible for ensuring Patient Service Representatives provide exceptional customer service, accuracy and efficiency with assigned tasks, and a positive patient experience that is consistent with CHCFC values and mission.

Patient Services Representatives perform all core activities of CHCFC’s Patient Services Department, the centralized business operations department which manages patient registration, scheduling, insurance verification, and access to patient records for all services within the health center: Medical, Dental, Behavioral Health, Office Based Addiction Treatment, Sexual and Reproductive Health, Diabetes Education, Transportation, Navigator Services, and Community Health Workers.

REPORTS TO:

Patient Services Department Manager

FLSA STATUS:

Non-Exempt

PRIMARY MANAGEMENT RESPONSIBILITIES:

1. Represents the department with competency and professionalism, with a focus on excellent customer service.
2. Assists in recruitment, interviewing, orientation and training of new Patient Services Representatives.
3. Oversees scheduling of Patient Services Representatives, including PTO and call-outs to ensure appropriate coverage.
4. Assigns duties to Patient Services Representative staff as appropriate and monitors performance of duties.
5. Coordinates with Site Leads to maintain consistency in performance expectations and business operations protocols across Patient Services and Reception departments.

GENERAL PATIENT SERVICES REPRESENTATIVE RESPONSIBILITIES:

1. Adheres to patient privacy laws such as HIPAA and 42CFR and understands the importance of confidentiality in maintaining trusting patient relationships.
2. Monitors and maintains proficiency with all forms of communication adopted by the Health Center; instant messaging, inter-office mail, EMR messages, and email.
3. Is able to cover pertinent functions in short staffing situations:

• Answers phone calls and retrieves messages from multiuser queues in a professional and welcoming manner.
• Utilizes appropriate translation services when customers/patients call in using any language other than English.
• Schedules appointments with use of schedule templates to minimize errors in appointment scheduling.
• Registers customers/patients over the phone with accuracy to insure data integrity.
• Actively promotes use of the patient portal with customers/patients and is able to facilitate basic troubleshooting of portal issues.
• Conducts outreach to customers/patients in need of follow up care in the organization
• Records and processes customers’ payments through a third party system. Responsible for scanning of medical records into the electronic medical record (EMR) system; to include records received from previous providers and specialists, as well as CHCFC New Patient registration packets.
• Screens old records for pertinent historical information needed (i.e. dates of previous pap smears, mammograms, colonoscopies, surgeries, etc.) and documents information in designated EMR fields.
• Ensures accuracy of scanning electronic records into correct customers charts and designated areas of electronic storage.
• Processes fax requests, including sending correspondence on behalf of CHCFC clinical teams, referrals, and responding to medical record requests. Distributes incoming faxes.
• Maintains postage machine and manages incoming/outgoing mail.
• Maintains the after-hours calls portal, to include: retrieval of both non-urgent phone messages and nurse triage notes. Responsible for dissemination of messages to appropriate staff for follow-up action
• Provides general clerical support to reception teams, including assisting with scanning of registration updates and other office tasks as assigned
• Prepares customers letters from available templates.

• Discovers, documents and verifies insurance information accurately for customers/patients
• Conducts routine insurance eligibility checks prior to scheduled visits.
• Identifies insurance coverage gaps and generates “Good Faith” payment estimates for patients within mandated notification time frames.
• Conducts outreach to potential customers/patients who have been assigned to the Health Center via their insurance company. The PSR is able to explain insurance enrollment options and assist patients with making decisions that are best for themselves and their families when choosing a primary care provider and enrolling in services.

REQUIRED SKILLS, EDUCATION & EXPERIENCE:

Education: High School or equivalent education required, Associate’s or advanced training in skills related to medical/dental office setting preferred.

Experience: 2+ years’ Medical or dental office experience required. Knowledge of office operations and basic computer operations required.Ability to work with a diverse population and sensitivity to low-income populations required. Public health or Federally Qualified Health Center experience preferred. Bilingual/bicultural background preferred.

Skills: Strong commitment to CHCFC Mission. Strong interpersonal and communication skills.

Ability to work with a diverse population and sensitivity to low-income populations.

PHYSICAL DEMANDS:

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. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is required to stand, walk, sit, use the hands to finger, handle or feel objects, tools or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch or crawl; talk or hear; taste or smell. Must be able to lift and/or move up to 25 pounds. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception and the ability to adjust focus.

WORKING CONDITIONS:

While performing the required duties of this job, the employee is exposed to weather conditions prevalent when traveling between Health Center locations where medical care is provided. This position performs tasks that involve exposure to blood, body fluids or tissues.

This job description is subject to review in the light of changing circumstances and is not intended to be rigid and inflexible but should be regarded as providing guidelines within which the employee works. Performs other duties as assigned.