Patient Services Representative

Patient Services Representatives.fy26.docx

Position Title: Patient Services Representatives

Division: Corporate Services

Reports To: PSR Manager

Job Summary:

Primary responsibilities involve providing registration and eligibility services to obtain and process demographic

and insurance information for alternate resources, Purchased Referred Care services, Marketplace Sponsorship

Program, and private/commercial insurance. The incumbent is responsible for scheduling, rescheduling and

maintaining the clinic schedule of their assigned area. This position uses the patient schedule system to check-in

scheduled and un-scheduled visits within the Oyate Health Center (OHC). The position requires the incumbent to

work on a rotating basis.

Specific duties include, but are not limited to:

• Answers telephone and greet visitors; provides information and assistance; and resolves problems.
• Gathers patient demographic information, updates patient information, and registers patients in the electronic system; determines eligibility for services; and obtains documentation of Indian blood or other documentation of Tribal membership.

• Obtains and verifies the health records and RPMS/BPRM Patient Registration information including Medicaid, Medicare, private/commercial insurance eligibility prior to clinic visits.

• Interviews patient to gather information to determine if a new health record needs to be established or If a health record needs to be reactivated.

• Assists patients in completing new or have update forms for the RPMS/BPRM Patient Registration System.
• Prepares documents and obtains patient’s and/or guardian’s signature on required forms as needed, either scans documents or routes documents to others appropriately.
• Ensures that minor consent forms are prepared, completed, and filed in patient medical chart and scanned into Vista.
• Maintains, key-enters, updates, and verifies all Alternate Resources data necessary for patient registration and for accurate billing and make corrections necessary to improve the Patient Registration System.

• Assists with orientation of new personnel and provides orientation and training specific to front desk processes as needed.

• Works in coordination with Benefits Coordinators to establish patient eligibility for the Marketplace Program, and Medicaid applications. Completes necessary tracking forms and turn in weekly or as requested.

• Provides reports in accordance with the established schedule and format as requested.
• Maintains adequate supply of required forms/documents.
• Participates in performance improvement teams and other committees as assigned.
• Must comply with federal laws and regulations as required by the Health Insurance Portability and Accountability Act (HIPAA).

• Performs the core responsibilities of the position accurately, timely, and in accordance with established standards.

• Maintains regular and reliable attendance consistent with the position’s schedule and operational needs.
• Communicates effectively with internal and external stakeholders as required by the role.
• Adheres to all applicable policies, procedures, and regulatory requirements.

• Utilizes required systems, tools, and technology necessary to perform the job.
• Responsible for completing assigned portions of multiple reports accurately and on time.
• When necessary, schedule appointments and follow up appointments.
• Supports the process of MVO transportation by submitting ride requests and/or cancellations when needed.

• Performs related duties.

Minimum Qualifications

• High school diploma or equivalent.
• One (1) year of administrative office support experience sufficient to understand the major duties of the position, and to be able to answer questions and resolve problems. Experience in a healthcare setting is preferred.
• Must successfully pass a criminal and background check, and a pre-employment drug screen.

The GPTCHB is a tribal organization which follows tribal preference laws. It is our policy to give preference to qualified Indian/Tribal candidates over a qualified non-native candidate in hiring decisions, if all other qualifications are equal.

Employment is contingent upon the outcome of all required criminal background checks and pre-employment drug screen.

Compliance with our Employee Health Procedure is a condition of employment. You are required to agree that you will comply with all job-related employee health screening and immunizations prior to your first day of employment. Jobs require that you have documentation that you have completed the following immunizations prior to your first day of employment: MMR (Measles, Mumps and Rubella, Varicella (Chicken Pox), Hepatitis B, Influenza, T-dap (Tetanus - Diphtheria - Pertussis), and COVID-19 vaccination is required .

This position requires the ability to perform the essential functions of the job, with or without reasonable accommodation. Physical demands and work environment may include:

• Primarily sedentary work is performed in an office or administrative setting.

• Requires the ability to sit for extended periods and regularly use standard office equipment such as a computer, keyboard, telephone, and copier.

• Occasional standing, walking, bending, and reaching may be required.

• Ability to lift and carry office materials or supplies up to 25 pounds occasionally.

• Requires manual dexterity and visual acuity for computer use and document review.

• Must be able to read, write, speak, and hear.

• Work is performed primarily in an indoor office or administrative environment.

• The environment involves everyday risks or discomforts that require normal safety precautions typical of office settings, including proper use of office equipment and awareness of trips, falls, and fire regulations.

• The work area is adequately lighted, heated, and ventilated.

• Minimal exposure to hazardous conditions; no routine exposure to clinical, field, or high risk environments.

• Occasional attendance at meetings, training sessions, or events may require travel within the organization's facilities.

The employee must comply with all organizational policies, procedures, and applicable laws and regulations. This position is subject to Native Preference, background checks, health requirements, and other applicable organizational standards.