PATIENT SERVICES REPRESENTATIVE MEDICAL

Patient Services Representative Medical

POSITION SUMMARY:

The Patient Services Representative will provide patients and staff with necessary assistance in fulfilling the needs of the center. They are responsible for patient check in/out, verifying and updating all demographics and insurances, collecting payments, identifying/enrolling patients on the Sliding Fee Scale, processing various forms and documents, and notifying appropriate persons of messages and information as required. Responsible for recording all necessary personal information, securing required signatures, preparing and supplying data to various departments. Will assist with efficient and effective coverage for the Patient Services Department. Provides service internally and externally consistent with ANHC mission, vision and values: Respect, Compassion, Personal Integrity, Excellence & Collaborative Spirit.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Performs opening and closing procedures.
• Answers and accurately processes multi-line phone calls to individual extensions or operator, medical, or billing queues regarding patient billing, appointments, and general inquiries.
• Responsible for scheduling, cancelling, or rescheduling appointments.
• Responsible for check in/out processes of each patient. Verifies and updates patient demographics, insurance and eligibility, unapplied credits, and guarantor due balances for all new and established patients.
• Collection of appropriate payment based on estimated charge, proper co-pay, deductible, discounted self-pay amount, or past due account balances.
• Responsible for cash management and daily reconciliation of all financial transactions performed.
• Patient accounts analysis including a general understanding of medical, dental, laboratory, radiology coding and billing standards. This includes ICD 10, diagnosis, patient rights and responsibilities, third party reimbursement, in/out network, contractual allowances, co-pays and deductibles.
• Verifies/updates insurance eligibility and reviews co-pays, co-insurance, deductibles, non-covered charges, and prior authorizations.
• Accurately prepares various medical forms requiring knowledge of ICD 10 codes diagnosis including but not limited to New Patient paperwork, Sliding Fee applications, Verification of Diagnosis (VOD), and Qualifying Diagnosis Certification (QDC).
• Effectively communicates with staff and patients.
• Various intermittent, periodic and systematic report completion including unapplied, accounts receivable, credit analysis and communication log.
• Prepares adjustments for authorization to adjust patient account balances for identified mistakes and bad debt write-offs.
• Cross-trained to provide backup for any vacancy within the department.
• Promotes and provides service excellence to internal and external customers.
• Works collaboratively with all members of the Patient Services department as well as other ANHC departments to ensure all daily work is completed and enhancing the patient experience.
• Other duties as assigned.

SUPPORTING DUTIES AND RESPONSIBILITIES:

• Maintains a clean and orderly work area.
• Performs translation services if staff member is bilingual.
• Attends required meetings/trainings and participates in committees as requested.
• Monitors the waiting and front desk areas for cleanliness and straightens up area as needed.

KNOWLEDGE, SKILLS AND ABILITIES:

ANHC's Mission, Vision and Values: Actively supports ANHC's mission, vision and values. Includes using individual skills to add value to the mission : To be a trusted partner in every person's wellness by providing integrated, compassionate, and high-quality health care, regardless of ability to pay; and vision : Accessible care for a healthy Anchorage . Aligns actions around organizational values of RESPECT, COMPASSION, PERSONAL INTEGRITY, EXCELLENCE and COLLABORATIVE SPIRIT and gives priority to organizational mission, vision and values when making decisions.

Accountability: Takes ownership for delivering on commitments; owns mistakes and uses them as opportunities for learning and development; openly discusses his/her actions and their consequences both good and bad; has an ability to identify strengths and developmental opportunities and leverages insight to make adjustments to improve their effectiveness; courage to have difficult conversations.

Adapting to Change: Accepts and adapts to change in a professionally appropriate and thoughtful manner. Is willing to offer a different perspective or approach and yet knows when and how to stand down graciously and accept a well-thought-out decision. Embraces change.

Confidentiality: Maintains the highest level of confidentiality regarding ANHC records and information relating to ANHC, its customers and employees. Appropriately uses internal confidential information for business purposes only. Responsible for knowledge and compliance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

Communicating Effectively: Shares information. Listens and involves others. Clearly conveys ideas in a manner that engages others and helps them understand and retain the message.

Decision Making/Judgment: Approaches problems and decisions methodically and objectively; involves others as needed; uses sound judgment in making decisions and understanding the impact to themselves, customers, their team, and the organization; conducts the appropriate analysis to identify the symptoms and root cause of issues; makes timely decisions.

Delivering High Quality Work: Makes sure responsibilities central to the role meet all requirements and expectations. Finishes tasks promptly and critically reviews work to ensure quality and accuracy. Considers impact of work to others and takes steps to mitigate. Seeks additional work after finishing tasks.

Demonstrating Initiative: Takes action on his/her own without being prompted; handles problems independently; able to resolve issues without relying on extensive help from others; does more than is expected or asked.

Results Orientation: Is focused on outcomes and accomplishments; follows through on commitments; can be counted upon to successfully execute on goals; motivated by achievement and a need for closure; has an attention to detail and is both efficient and effective in achieving a high level of measurable outcomes; persists in achieving goals despite obstacles.

Service Excellence: Has a desire to consistently provide a genuinely exceptional experience to every person, every time. Provides timely and professional service to both internal and external customers; is responsive to customer needs and requests; is always courteous to the customer and considers the needs of the customer when making decisions.

Teamwork: Meets all team deadlines and responsibilities, listens to others and values opinions, helps team and leader to meet goals, welcomes newcomers and promotes a team atmosphere.

PHYSICAL, SENSORY, ENVIRONMENTAL QUALIFICATIONS:

The work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

Duties of this job require frequent sitting, writing, typing, grasping, seeing, hearing and speaking for long periods of time. Frequent use of computer, keyboard, copy and fax machine and phone. Occasional standing, walking, reaching, bending, stooping, lifting and carrying. Lifting, carrying, pushing and pulling up to 25 pounds. Must be able to work evenings and weekends as scheduled.

Work is performed in a healthcare clinic and office setting. ANHC is a tobacco-free campus.

EQUAL EMPLOYMENT OPPORTUNITY STATEMENT:

Anchorage Neighborhood Health Center provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws. Anchorage Neighborhood Health Center complies with applicable state and local laws governing non-discrimination in employment in every location in which the organization has facilities. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training. Persons alleging unequal treatment should contact the Chief Human Resources Officer.

The undersigned have read this job description and agree that it defines the position as it currently exists. The undersigned also understands that the above is intended to describe the general content of and requirements for this job. It is not to be considered as an exhaustive statement of duties, responsibilities, or requirements and does not limit the assignment of additional duties at the discretion of the supervisor.

Qualifications

QUALIFICATIONS:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.

Work Experience: One to three years' experience in a medical office setting. One-year experience in the medical billing field, preferred. Must possess experience in healthcare administration, financial intake, customer service, and answering telephones.

Education, Certification and Licensure: High school diploma or the equivalent. AAPC, NCICS, CHCS or CPC certification may be substituted in lieu of required experience.

Additional Skills & Knowledge: Must be able to use a

Anchorage Neighborhood Health Center