Patient Service Rep II

The compensation range listed reflects the range Northern Light Health anticipates relying on in setting the wages for the position. The range may not necessarily include all additional compensation elements available such as differentials incentive programs and benefits.

Northern Light Eastern Maine Medical Center

Department:Primary Care - EMMC

Position is located: 925 Union Street

Work Type:Full Time

Hours Per Week: 40

Work Schedule:Variable

Salary Range: $18.25- $24.15

Exempt: No

Summary :

The Patient Service Representative II is an advanced support position and is responsible for a variety of activities related to patient in-take and care. The Patient Services Representative II is generally the first point of contact for patients entering the practice. It involves all of the responsibilities of the PSR I but with a higher level of competency and experience. Activities may include but are not limited to greeting and checking in patients verifying and updating insurance information and confirming other patient information scheduling patient appointments answering phones updating demographic information processing referrals payment collection and posting charge entry chart preparation and other duties as assigned with a minimum of support. The PSR may work with a fair amount of independence and serve as a resource to the PSR I.

Responsibilities :

• Demonstrates effective and courteous Customer Physician/Practice Staff and other hospital staff communication skills.
• Communicates in a way that conveys understanding and respect to a diverse patient and work population.
• Answers all calls promptly and courteously.
• Responds to and resolves issues promptly through effective communication.
• Uses appropriate chain of command.
• Feedback is provided in a constructive manner.
• Demonstrates problem solving skills by responding to and resolving issues promptly through effective communication skills.
• Maintains adaptability in work schedule to meet patient/departmental needs.
• Develops and maintains positive working relationships.
• Acts as a resource to coworkers.
• Confirms patient identity by using the full name.
• Participates in problem solving groups as requested.
• Gives instructions and directions in a clear understandable manner.
• Handles patient/family situations that have been escalated to the PSR II in a calm courteous and informed professional demeanor.
• Greeting patients having patient(s) sign appropriate forms/consents.
• Verifying and updating demographic/insurance information on all encounter forms and systems per protocol.
• Notifying registration of changes if applicable.
• Demonstrating mastery of appropriate practice software and registration tool protocols.
• Scheduling tests procedures referral appointments with scheduling center agencies and/or other provider groups and forwarding order form and/or records to appropriate depart/office and documenting information in patients chart. Processing insurance referral/prior authorization and document this per protocol.
• Retrieving and processing messages per protocol.
• May assist with orientating and training/cross-training of new and established employees as assigned.
• May provide coverage in other areas.
• Effectively covers other support positions (e.g. switchboard insurance referrals scheduler) if appropriate
• Takes ownership for determining customers needs and offers assistance.
• Interacts with other Organization functions with confidence courtesy and professionalism.
• Assists the practice manager in organizing coordinating and implementing projects.
• Collects and compiles statistical data to assist the practice manager as required.
• Schedules outpatient testing per orders/referral process inputs appointment dates and times into patient EMR if appropriate
• Recognizes problems and offers constructive solutions. Is able to implement solutions with direction from the practice manager.
• Performs other duties as assigned by practice leadership.
• Able to cover most front office positions if appropriate.
• 100% documented evidence of attendance of department staff meetings and/or reading/initializing the minutes.
• Reviews material submitted by Health Plans and Managed Care Organizations to gain full understanding of benefit coverage and precertification/authorization if appropriate.
• Quality review procedures are followed to ensure accounts are brought to a timely and accurate resolution if appropriate.
• Ability to prioritize and perform multiple duties simultaneously.
• Ability to take ownership of work and follow up on responsibilities.
• Speaks spells and writes clearly concisely and to the point.
• Consistently follows Patient Identification IDD by using two patient identifiers related to the registration process.
• Patient Identification Manager will be alerted if duplication medical record numbers are identified.
• Proper name format is consistently followed.
• Managed care organizations are correctly identified and selected as part of the registration process if appropriate.
• Timely modifications of registrations are done in order to ensure billing of encounters.
• Uses independent judgment when necessary if appropriate
• Assists Practice Manager with patient complaints related to billing invoices if appropriate.
• Appropriately refers patients/staff with issues/concerns to the Practice Manager.
• Performs Service Recovery when necessary.
• Has 100% of iCare employee updates and any other in-services meetings and training as assigned.
• Maintains documented evidence of continuing education.
• Works safely and follows all safety policies reports incidents or hazards immediately.
• Follows all hand hygiene protocols.
• Strong knowledge of departmental policies procedures and workflows
• Insurance verification and precertification is performed prior to elective inpatient admission to ensure accounts are secured upon admission if appropriate.
• For all other non-scheduled inpatients insurance verification and precertification is performed within 24 hours of admission or by the end of the business day to perform due diligence on accounts that admitted the previous day if appropriate.
• Names dates and times of conversations with businesses insurances managed care organizations Utilization Review and patients are documented if appropriate.
• Insurance verification and precertification is performed on high dollar outpatient areas to ensure reimbursement if appropriate.
• Understands the implication both clinically and financially of registration errors and the impact on the organization if appropriate.
• Referral calls are made to PCP for Managed Care patients if appropriate.
• Correct insurance is identified and selected when appropriate within the registration fields.
• Policy numbers are entered correctly into the registration fields if appropriate.
• Ensures that referral authorization numbers are submitted to Patient Account Services in a timely manner and understands the implications if this is not done if appropriate.
• Finishes work on time 95% of the time avoiding overtime.
• Prepares billing sheets and codes invoices prior to sending to Accounts Payable if appropriate.
• Collects payments (cash co-payments cash checks and other forms of payment for services rendered; reconciles cash drawer/journal per Organization policy; promptly secures/delivers the cash deposits in the designated safe or other designated area for transit to the Fiscal Services Department if appropriate.
• Oversees daily revenue reports and charge reconciliation if appropriate.
• Promotes services at Northern Light Health.
• Meets continuing education requirements set forth by the practice.
• Seeks opportunities for enhancement of skills.
• Assists with answering questions and directing practice staff to appropriate resources.
• Attends 100% of employee updates.

Other Information :

Competencies and Skills

• Behaves with Integrity and Builds Trust: Acts consistently in line with the core values commitments and rules of conduct. Leads by example and tells the truth. Does what they say they will when and how they say they will or communicates an alternate plan.
• Cultivates Respect: Treats others fairly embraces and values differences and contributes to a culture of belonging empowerment and cooperation.
• Fosters Accountability: Creates and participates in a work environment where people hold themselves and others accountable for processes results and behaviors. Takes appropriate ownership not only of successes but also mistakes and works to correct them in a timely manner. Demonstrates understanding that we all work as a team and the quality and timeliness of work impacts everyone involved.
• Practices Compassion: Exhibits genuine care for people and is available and ready to help; displays a deep awareness of and strong willingness to relieve the suffering of others.

Education

• Required High School Diploma/General Educational Development (GED)

Working Conditions

• Potential exposure to abusive and/or aggressive people.
• Work with computers typing reading or writing.
• Lifting moving and loading 20 to 30 pounds.
• Prolonged periods of sitting.
• Prolonged periods of standing.
• Prolonged periods of walking.

Northern Light Eastern Maine Medical Center is a 411- bed regional tertiary care hospital and an American College of Surgeons-verified Level II Trauma Center. Located in Bangor Maine it serves as the principal referral center for a patient population of 500000 residents across the northern two-thirds of the state. The medical center provides comprehensive inpatient and outpatient services including advanced surgical care neurosciences cardiovascular medicine oncology and critical care.

Eastern Maine Medical Center is the base for LifeFlight of Maine a critical care air medical transport program that conducts nearly 900 missions annually ensuring timely access to specialized care for rural and remote communities. As a member of Northern Light Health the medical center is part of an integrated statewide health system comprising nine hospitals numerous primary and specialty care practices long-term care facilities home health and hospice agencies and emergency ground and air transport services. This integrated model supports coordinated patient-centered care across the continuum.

Eastern Maine Medical Center plays a central role in advancing clinical quality operational efficiency and health equity throughout the region. It is actively engaged in clinical education and serves as a training site for medical students residents and fellows through affiliations with academic and professional institutions.

Bangor Maine offers a stable and supportive environment for healthcare professionals. The region is home to high-performing public and private schools including the University of Maines flagship campus in Orono. Bangor International Airport provides convenient commercial air service with direct and connecting flights to major US hubs. The area also offers access to a wide range of cultural educational and recreational opportunities with outdoor activities available year-round in Maines forests lakes mountains and coastal regions.


Northern Light Eastern Maine Medical Center is a strategic hub for clinical excellence innovation and community health in northern New England.

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EMMC Bangor Maine Level 2 Trauma Center hospital Cancer Care