Lead Patient Service Representative

Lead Patient Service Representative

This non-exempt, onsite job is located at the Friendship Ambulatory Surgery Center, in Chevy Chase, MD, which is part of Prism Vision Group. There will be occasional travel to other locations based upon business needs.

Compensation Range: $19.30-$40.15/hr (Dependent on Experience)

The Lead Patient Service Representative is responsible for ensuring front desk operations and supporting Patient Service Representatives in delivering the full scope of patient access functions. This includes inbound and outbound interactions (telephone, internet, or in-person), patient scheduling and logistics, executing daily workflows (cancellations, missed visits, tickler-recall deployment), and revenue cycle tasks such as claim scrubbing and missing slip completion. Oversees staff scheduling, time and attendance; e.g. vacations, sick/personal time, etc.

Role And Responsibilities

• Oversees staff scheduling, time and attendance; e.g. vacations, sick/personal time, etc.
• Ensures staff are familiar with job requirements, expectations, and safe and proper use of facilities and equipment.
• Schedule and accurately complete full registration for patients requesting appointments while adhering to policies and procedures regarding scheduling and registration processes.
• Initiate pre-registration and ensure all demographic and insurance information is accurate, complete, and up to date in patient records.
• Verify insurance information, benefits, and referral requirements.
• Obtain legal photo identification and insurance cards (if applicable) and validate patient identity and coverage prior to services to ensure safety and reimbursement.
• Adhere to HIPAA standards related to patient privacy and confidentiality.
• Ensure smooth patient flow through the clinical care process.
• Provide patients with required information regarding appointments and payment policies (e.g., medical records, parking, cash policies, anticipated charges, cancellation policy).
• Offer upfront financial counseling at check-in, including identifying alternate funding resources and establishing payment plans.
• Advise patients of financial obligations and collect funds according to established guidelines.
• Act as a liaison/advocate for patients, physicians, and staff to facilitate ease of care; identify and resolve issues impacting service delivery.
• Notify appropriate parties of appointment times, referral criteria, insurance verification, and prior authorization requirements.
• Train other Patient Service Representatives and model excellent customer service skills.
• Comply with company policies and standards.

Position Qualifications

Education: High School Graduate or General Education Degree (GED). Bachelor's degree in relevant discipline preferred. Experience: 8+ years of experience as patient services representative required, including 2+ years of leading other team members.

Knowledge/Skills/Abilities

Working knowledge of medical symptoms, signs, and anatomical systems to identify and differentiate type and urgency of medical need. Knowledge of insurance referral requirements to ensure access based on third party reimbursement criteria. Excellent verbal and written communications skills in English. Bi-Lingual a plus. Must possess excellent, critical thinking, analytical, troubleshooting, problem resolution, and customer service skills. Excellent mathematical and cash management skills. Excellent interpersonal skills and ability to work effectively with physicians, co-workers, other departments and patients of all ages, and from across a broad range of cultural and social economic backgrounds. Knowledge of medical terminology preferred. Ability to work as an integral team member under minimal supervision, in a fast-paced, complex and highly stressful environment. Computer literate and ability to use multiple systems and acquire proficiency in multiple electronic systems. Proficient with Microsoft Office Suite.

Work Environment

An office environment with a controlled atmosphere. Possible exposure to staff or patients with communicable diseases and blood borne pathogens.