Patient Access Representative I

Overview Job Title: Patient Access Representative I (PAR I) Department: Patient Services – Clinical Operations Supervisor: Health Center Manager Location: Hyattsville, MD Classification: Non-Exempt/Hourly Synopsis At La Clinica del Pueblo, the Patient Access Representative I (PAR I) plays a fundamental role daily by supporting a range of tasks to ensure smooth operations. PAR I serve primarily as the entry point for answering incoming phone calls received through our Contact Center and scheduling appointments for our clinical and mental health services. PAR I must display excellent customer service, communication, interpersonal, and organizational skills, and the ability to handle a high volume of calls in a fast-paced environment. This role facilitates accessing care via telephone, messages through the patient portal, and distribution of telephone encounters. Qualifications Required Education and Experience High school diploma or GED required; Associate degree preferred. One (1) year of exceptional internal and external customer service and ability to work with diverse, underserved populations and the LGBTQ+ community. One (1) year of experience with insurance verification and benefits eligibility. In place of one (1) year of experience, a combination of understanding and articulating insurance benefits and willingness to learn. Ability to follow La Clinica’s Standard Operating Procedures (SOPs) and adhere to Scheduling Guidelines. Preferred Education And Experience One to three (1-3) years of experience in a healthcare or call center preferred. Multi-line phone system; Dialpad a plus. Excellent verbal and written communication, professional telephone manner, interviewing, and interpersonal skills to interact with patients, families, members of the health care team, and external agencies. Analytical and critical thinking skills to resolve conflicts and problem-solving to meet the patient’s needs. Data entry skills with the ability to check the accuracy of detailed work. Maintain high productivity and work well in a team environment. Bilingual in English and Spanish with effective verbal and written communication skills. Required Skills/Abilities/Certifications/Licenses Compassion to assist patients and caregivers in challenging situations. Strong organizational skills to keep patient information confidential and organized. Problem-solving skills for scheduling conflicts, missing documentation, and other challenges. BLS or CPR certification or willingness to obtain within 90 days of employment. Preferred Skills/Abilities/Certifications/Licenses Knowledge of medical terminology and practices. Ability to maintain patient confidentiality and adhere to HIPAA regulations and PHI. Ability to function in high-volume, multiple-task environments in a closely shared workspace. Primary Essential Duties And Responsibilities Ensures that all documentation provided to the patient is correctly filled out and signed by the responsible party according to the workflow. Answer any questions as needed. Attends required all-staff meetings and LCDP activities training to increase/maintain skills and complete competency checklists within 90 days of employment and annually. Participates in disaster programs and monthly drills as appropriate. Maintains current professional skills and continues professional growth to enhance the performance and image of the organization. Actively participates in the Patient-Centered Medical Home (PCMH) change process to support the organization’s transformation. Participating in ongoing training to stay updated on medical procedures, policies, and regulations. Completes assigned tasks and responsibilities within established guidelines and scope of practice. Collaborating and communicating with clinical staff to ensure smooth patient flow and efficient service delivery. Ability to communicate affirmingly, respectfully, and efficiently with staff and patients. Adheres to La Clinica del Pueblo’s Code of Ethical Standards, ensuring excellent internal and external customer service and patient experience throughout all interactions. Enforce LCDP’s policies and procedures to patients; seek management support as required. Performs other tasks as needed under the direction of the Health Center Assistant Manager. Front Office Customer Service Checks patients in for their appointments. Assisting patients with pre-registration and insurance verification. Informs, collects, and processes patient payments, including SFS, account balances, copays, diabetes supplies, prenatal vitamins, and patient donations. Refer patients to the billing department for payment plans or insurance-related inquiries. Reconciles daily cash reports. Provide educational materials related to their visit. Enrolls and directs patients to the patient portal; reminds established patients that they can access their medical information and request appointments and medication refills. Complete administrative tasks, including reviewing and managing tasks assigned to the Patient Access Representative team. Schedule the patient’s follow-up and any upcoming pre-visit laboratory orders - schedule the patient’s next appointment(s) and necessary laboratory tests before the next visit according to the protocol of each condition or as directed by the provider. Ensure patients have necessary referrals, appointment summaries, prescriptions, scheduled follow-up appointments, recall system entry, and any required documentation before departure. Contact Center Handle multi-line telephone systems courteously, directing calls to the relevant team and documenting patient interactions in telephone encounters (TE) in electronic health records (EHR). Promptly respond to incoming calls, Healow messages (Patient Portal), voicemails, pharmacies, and outside agencies seeking assistance, ensuring exceptional service delivery. Contact unconfirmed patients on the schedule for whom eCW has not reached out for confirmation. Assisting patients with pre-registration and insurance verification. Schedules ASL and language interpreters when appointments are scheduled. Manage appointment status calls, including rescheduling and cancellations of medical appointments. Enrolls and directs patients to the patient portal; reminds established patients that they can access their medical information and request appointments and medication refills. Coordinate pending provider recalls and arrange appointments accordingly. Completes pre-registration for patients, schedules appointments with Patient Access Representative II, and advises patients on necessary documentation to complete the registration process, including insurance enrollment or renewal requirements. Adhere to La Clinica’s Scheduling Guidelines when booking the Clinical Services and Mental Health team templates. Communicate all unforeseen challenges to the Health Center Manager. Physical Requirements Prolonged periods of sitting at a desk working on a computer and handling a high volume of incoming and outgoing calls. Must be able to lift at least 15 pounds at times. Note: Supervisory Responsibilities: None #J-18808-Ljbffr La Clinica del Pueblo