Patient Service Representative

The Patient Service Representative (PSR) works under the direction of the Health Center Manager. The PSR is responsible for ensuring internal and external clients are provided with exceptional customer service. Duties include, but are not limited to performing patient intake, collecting and verifying patient information, handling cash collections, patient copays and credit card transactions, coordinating phone calls, scheduling patients via the computerized scheduler, and verifying eligibility/insurance information and health care benefits to ensure accurate billing procedures. Other duties include scanning/inputting required patient information into the electronic medical record, assisting with patient referrals and program services, and performing other duties as assigned.

ESSENTIAL JOB DUTIES AND RESPONSIBILITIES:

1. Supports and implements the organization's vision, mission and values.
2. Determines priorities and method of completing daily workload to ensure that all responsibilities are carried out in a timely manner.
3. Performs all job functions in a professional and courteous manner. This includes answering all phone calls and emails timely and providing excellent customer service to internal and external customers.
4. Fosters and promotes a culture of service excellence and accountability.
5. Performs timely and accurate patient registration and patient flow tracking in accordance to health center procedures. Determines and verifies patient program/insurance eligibility requirements. Registers patients by verifying that patient's record is up to date and accurate. Makes appropriate changes in computer system and on electronic health record.
6. Demonstrates the ability to identify the patient's account via date of birth or name search; creates accounts for new patient appointments; and verifies and updates demographic information. Knows and follows eligibility requirements and verification processes for coverage programs. Enters confidential personal health information and financial information into computerized system accurately. Complies with federal and local laws in ensuring patient privacy. Schedules, confirms and cancels appointments; coordinates walk-in patients; follows up with providers for canceled/no show appointments. Utilizes the appointment template to meet or exceed productivity standards.
7. Collects payments and co-pays from patients; obtains authorizations for credit card transactions. Applies payments and adjustments to patient accounts in the computer system accurately and reconciles daily cash reports. Adheres to cash collection policies and procedures
8. Answers telephone calls timely, courteously, and professionally. Follows telephone decision-making guide correctly. Utilizes the computer system correctly to obtain requested information, update demographic files and/or make, cancel, and reschedule appointments. Provides appointments and information; documents and forwards calls when appropriate and takes detailed messages when required. Completes and submits departmental requests for information and reports.
9. Examines patient's records/medical reports/consultation reports and verifies patient identification. Identifies forms and the appropriateness for inclusion in the medical record. Scans/indexes/commits images into the electronic health record per protocol.
10. Checks/reviews paperwork filed in paper medical charts against scanned documents saved in Electronic Health Records to determine if documents have been electronically stored properly ("quality check").
11. Uses discretion and good judgment in handling sensitive or confidential information and understands which decisions can be made alone and which decisions need to involve others.
12. Complies with organizational policies and procedures, specifically the Records Management and Retention Policy & Procedures.
13. Retrieves medical records and delivers to appropriate providers or department. Files patient and administrative files.
14. Copies and faxes documents as required. Perform duties with the ability to focus on details and multi-task.
15. Performs all other duties as assigned.
16. Must be willing and able to work at all locations as needed to meet patient care needs.
17. Must be willing and able to work all business hours including evenings and weekends.

QUALIFICATIONS:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

EDUCATION/EXPERIENCE:

1. High School Diploma or equivalency required.
2. Five years of healthcare related customer service or two years of patient intake/registration required.
3. Working knowledge of insurance verification/eligibility insurance programs (Commercial, Medi-cal, MediCare and sliding fee programs) required.
4. PC or word processing experience required.
5. Medical coding experience preferred.
6. Certificate in billing and coding and/or Medical Terminology preferred.
7. Experience with electronic health records and practice management systems required, familiarity with EPIC preferred.
8. Excellent telephone and interpersonal communication skills. Must demonstrate superior professionalism when dealing with clients, staff, and vendors, required.
9. Familiarity with Current Procedural Terminology (CPT) and International Classification of Disease (ICD) coding a plus.
10. Bilingual in English/Spanish preferred.

LANGUAGE SKILLS:

Ability to read and interpret documents, such as policies and procedures, benefits information, benefit surveys, board minutes, routine mail, simple contracts, and instruction manuals. Ability to compose routine reports and correspondence. Ability to speak effectively with employees, visitors and management.


MATHEMATICAL SKILLS:

Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, and apply concepts of basic algebra and geometry.

REASONING ABILITY:

Ability to exercise common sense in carrying out instructions furnished in written, oral, or diagram form and in other daily situations that arise. Ability to deal with problems involving several concrete variables in standardized situations. Ability to make decision and execute timely in order to produce a positive outcome. Ability to work independently, set priorities, and work well under pressure.

OTHER SKILLS AND ABILITIES:

This position requires the following minimum requirements:

1. Knowledge of office equipment including copier, fax machine.
2. Skill in dealing with interpersonal issues and customer relations.
3. Ability to handle multiple priorities at once with minimal supervision.
4. Ability to comprehend and follow written and verbal instructions.
5. Ability to organize and communicate clearly.
6. Ability to maintain confidentiality of patient and employee information.

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 regularly required to use hands to finger, handle or feel and reach with hands and arms. The employee frequently is required to stand, walk, and sit. The employee is occasionally required to climb or balance, stoop, kneel, crouch or sit. The employee must frequently lift and/or move up to 10 pounds and occasionally life and/or move up to 30 pounds. The employee is occasionally required to ascend and descend one flight of stairs. Specific vision abilities required by the job include close vision, color vision, and ability to adjust focus.

WORK ENVIRONMENT:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The noise level in the work environment is often moderate. However, there are many times when there is a high ambient background noise of phones and multiple conversations. Must be able to screen out the background noise to concentrate on the work at hand.