Patient Services Representative

Job Description

Job Description:\n\n Purpose of Position:\n The purpose of the Front Office Team Member position is to support the delivery of high-quality, patient-centered pediatric care by serving as a welcoming, knowledgeable, and reliable first point of contact for children and their caregivers. This role ensures efficient front office operations that promote access to care, positive patient experiences, and the financial sustainability of the health center through accurate, compassionate, and professional administrative support.\n \n Contribution to Carevide’s Mission:\n The Front Office Team Member plays a vital role in advancing the health center’s mission by creating a welcoming, safe, and family-centered environment for children and their caregivers. As the first and last point of contact, this position helps set the tone for each visit by demonstrating warmth, patience, and professionalism in every interaction.\n Access to Patient & Family-Centered, High Quality Care: This role supports access to high-quality pediatric care by assisting families with scheduling, insurance, referrals, and administrative processes clearly and compassionately, recognizing that caregivers may be navigating stress, time constraints, or complex systems. Through culturally sensitive and compassionate interactions, the Front Office Team Member helps build trust with families, reduces barriers to care, and supports positive, long-term relationships that promote children’s health and well-being. By collaborating closely with clinical teams and upholding the organization’s values, the Front Office Team Member contributes to a positive patient experience and helps ensure that every child and family feels respected, supported, and cared for.\n Financial Success & Sustainability of the Mission: The Front Office Team Member supports the financial sustainability of the health center by ensuring accurate and timely collection of patient information, insurance details, and required documentation. By helping families understand coverage, eligibility, and financial processes clearly and respectfully, this role reduces barriers to care while supporting appropriate reimbursement for services provided. Through attention to detail, effective communication, and collaboration with billing and clinical teams, the Front Office Team Member helps minimize errors, delays, and insurance claim denials that can impact revenue. By fostering positive, trusting relationships with families and encouraging continuity of care, this role contributes to patient retention and the long-term financial health of the pediatric center, ensuring the health center can continue to serve children and families in the community.\n \n Essential Responsibilities of Check-in\n Position Summary\n Check-in is responsible for delivering a high-quality, patient-centered experience by managing front desk operations, coordinating patient check-in, and ensuring accurate registration, and payment collection. This role plays a critical part in maintaining efficient clinic flow, data accuracy, and compliance with Carevide’s policies.\n Patient Experience & Customer Service \n \n Greet patients, families and caregivers in a professional, patient-centered manner and assist with questions or concerns. \n Utilize the AIDET customer service model to ensure patients and caregivers are consistently acknowledged and informed throughout their visit. \n Maintain professionalism in managing patient concerns, conflicts, or lobby disturbances and notify the supervisor when necessary. \n Identify and escalate any potentially infectious patients upon arrival following clinic protocols. \n Coordinate and notify staff of time-sensitive visits, including proper workflows for rooming “48-hour babies.” \n Monitor patient progress through registration and eligibility process and assist patient, or caregiver in maintaining efficient clinic flow. \n \n Patient Registration & Intake Management\n \n Verify patient identity using appropriate identifiers to ensure accurate account and chart access. \n Review patient appointment notes, registration alerts and Patient FYIs in Epic to identify if additional financial information or PCP change is required prior to check in; direct to eligibility as appropriate.\n Resolve all registration alerts and eligibility exceptions prior to completing check in.\n Verify, and update if needed, all patient demographic information including but not limited to:\n \n Address\n Phone Number(s), \n Email Address, \n Guarantor information based on visit type\n Financial/Insurance Changes\n \n Review patient registration forms to identify documents requiring annual renewal, ensure all required information is updated, and obtain patient or caregiver signatures in accordance with Carevide policies and Epic workflows. Forms include, but not limited to:\n \n Patient Acknowledgement\n Authorization to Release Information\n UDS Intake Form\n Sliding Fee Discount Program screening\n \n When applicable, update the family size and income within the patient’s chart based on the UDS Intake Form. \n Capture patient photos in accordance with organizational procedures. \n Collect and copy valid IDs and current insurance cards (front and back) when not obtained through the patient portal.\n Ensure correct guarantor is added to visit based on program and visit type.\n Create and attach Claim Information record in Epic when required based on the visit type, payer, or program eligibility including:\n \n Family Planning\n Early and Periodic Screening, Diagnostic and Treatment (EPSDT)\n \n Complete the check-in process ensuring active insurance payer(s) are added in correct filing order or grant program is attached based on visit type.\n Update appointment status in Epic according to Carevide’s Epic workflow:\n \n “Present” - when patient arrives\n “Arrived / On-site - Good to Go” - when all registration and financial requirements are complete and patient is ready for the clinical team.\n \n \n Scheduling & Appointment Coordination\n \n Assist patients and caregivers of walk-in patients with scheduling same-day or future appointments as needed.\n Perform daily appointment confirmation calls the day prior to scheduled visits and clearly communicate the following to the patient or caregiver: \n \n Time of arrival for appointment\n Expected payment amounts\n Required documentation needed for financial screening (ex: proof of income) or billing of insurance\n \n \n Payment Collection & Account Management\n \n Collect and post patient payments, including co-pays, co-insurance, and sliding fee amounts to the patients account in Epic. \n Provide the patient or caregiver with a receipt for all collected payments. \n Follow Carevide’s collection procedure for OB patients on a self-pay agreement. Follow Carevide’s collection policy for patients unable to pay at time of service. \n Inform patients or caregivers of outstanding balances from previous visits and collect payment following Carevide’s collection policy. \n Review accounts for credit balances and coordinate with the billing team to apply credits to current visits as appropriate.\n Reconcile daily cash and check collections against Epic “Cash Drawer” to ensure accuracy. \n \n Reporting & Administrative Responsibilities\n \n Assist front office team with daily scanning of patient documents and filing in the patient’s chart within the Epic system. \n Participate in scheduled lobby checks and communicate delays or extended wait times to patients. Lobby checks to be completed at 9:00a, 11:00a, 2:00p & 4:00p.\n Maintain compliance with Carevide’s policies, payer requirements, and regulatory standards\n Collaborate with front office team members to maintain a clean, organized, efficient, and patient-focused environment.\n Essential Responsibilities of Check-out\n Position Summary\n Check-out is responsible for ensuring accurate and efficient patient check-out, payment collection, and scheduling of follow-up care. This role plays a key part in revenue cycle integrity, patient satisfaction, and maintaining smooth clinic operations through effective communication, attention to detail, and adherence to organizational policies.\n Patient Experience & Customer Service\n \n Greet patients, families and caregivers in a professional, patient-centered manner and assist with questions or concerns. \n Utilize the AIDET customer service model to ensure patients and caregivers are consistently acknowledged and informed throughout their visit. \n Monitor patient progress through registration and eligibility process and assist patient, or caregiver in maintaining efficient clinic flow. \n Provide a positive closing experience by thanking patients and caregivers for choosing Carevide for their healthcare needs or some other expression of gratitude.\n \n Check-Out & Charge Processing\n \n Verify patient identity using appropriate identifiers to ensure accurate account and chart access\n Complete the check-out process in Epic, ensuring all visits are properly finalized, based on visit type, with current insurance payer(s) in the correct filing order or program payer attached if applicable.\n Review visits and ensure attachment and completion of “Claim Information” record for applicable insurance payers and grants payers based on type of visit.\n \n Family Planning: ensure information is updated with current date and services\n Early and Periodic Screening, Diagnostic and Treatment (EPSDT)\n \n Update appointment status in Epic according to Carevide’s Epic workflow:\n \n “Completed” - once all check-out processes are reviewed and completed. \n \n Review Appointment Status for visits completed by providers and ensure all visits are updated before end of day. \n \n Payment Collection & Reconciliation\n \n Collect and post any remaining patient balances at time of service, including co-pays, co-insurance, outstanding balances if applicable. \n Provide the patient or caregiver a receipt for all payments collected. \n Follow Carevide’s collection policies for patients unable to pay at time of service.\n Review accounts for credit balances and coordinate with the billing team to apply credits to current visits as appropriate \n Reconcile daily cash and check collections against Epic “Cash Drawer” to ensure accuracy \n \n Scheduling & Follow-Up Coordination\n \n Schedule follow-up and return appointments according to provider check-out instructions, recalls and health maintenance recommendations documented in Epic. \n Provide patients or caregivers with detailed appointment reminder card for scheduled visits.\n Assist patients, families and caregivers of walk-in patients with scheduling same-day or future appointments as needed\n \n Registration Support & Data Accuracy\n \n Retrieve and review incoming referrals and schedule appointment as indicated.\n \n Reporting & Administrative Responsibilities\n \n Ensure accuracy and completeness of documentation for each visit related to check-out and billing processes \n Complete daily deposit tasks including:\n \n Taking daily collected payment to the bank\n Complete deposit worksheet\n Scan required deposit documents to Finance daily by 4:00pm. \n \n Assist front office team with daily scanning of patient documents and filing in the patient’s chart within the Epic system. \n Participate in scheduled lobby checks and communicate delays or extended wait times to patients. Lobby checks to be completed at 9:00a, 11:00a, 2:00p & 4:00p.\n Maintain compliance with Carevide’s policies, payer requirements, and regulatory standards\n Collaborate with front office team members to maintain a clean, organized, efficient, and patient-focused environment.\n Essential Responsibilities of Eligibility\n Position Summary\n Eligibility is responsible for verifying insurance coverage, determining financial eligibility, and ensuring accurate patient financial information prior to and during visits. This role supports revenue cycle integrity and patient access to care by managing pre-registration, eligibility verification, and financial screening processes, including the Sliding Fee Discount Program. The position requires strong attention to detail, excellent communication skills, and a commitment to delivering a patient-centered experience.\n Patient Experience & Customer Service\n \n Greet patients, families and caregivers in a professional, patient-centered manner and assist with questions or concerns. \n Utilize the AIDET customer service model to ensure patients and caregivers are consistently acknowledged and informed throughout their visit. \n Verify patient identity using appropriate identifiers prior to discussing protected health or financial information. \n Maintain confidentiality and professionalism when discussing sensitive financial and insurance information. \n \n Pre-Registration Management\n \n Perform daily pre-registration process 6-7 days prior to appointment date, to verify:\n \n Current insurance coverage and benefits\n Current Referral and/or Pre-authorization on file in patient chart if applicable\n Current Sliding Fee screening \n Current enrollment in Grant Program if applicable to visit type\n Every patient chart is updated with current family size and income details \n \n Monitor schedules daily for newly scheduled patients and complete the pre-registration process prior to the patient’s visit.\n Update Patient FYI in Epic with insurance and financial details and ensure accuracy of pre-registration data.\n Work with scheduling staff and review Team Chat for newly scheduled patients who may need a referral and/or pre-authorization.\n Retrieve insurance information for new patients; process verification and contact patient or caregiver to explain benefits, patient cost share and referral/authorizations.\n \n Insurance Verification & Eligibility Management\n \n Verify insurance eligibility 6-7 days prior to appointments, including: \n \n Coverage status and benefits\n Primary Care Provider (PCP) assignment \n Primary and secondary coverage \n Patient financial responsibility (co-pay/co-insurance)\n Requirement for Referral and/or Prior Authorization for OB and GYN services \n \n Resolve all eligibility exceptions prior to the patient’s arrival when possible.\n Contact patient or caregiver to obtain missing or updated insurance information and facilitate PCP changes when needed prior to appointment. \n Update Appointment Notes with needed financial data if unable to obtain by contacting the patient or caregiver. \n Ensure current insurance cards (front and back) are on file in the patient chart. \n Add new insurance payers and terminate inactive coverage within Epic.\n \n Financial Screening & Sliding Fee Program\n \n Conduct financial screenings in a confidential setting to determine eligibility for available grant programs offered at Carevide. \n Ensure documentation and/or application for screened grant program(s) is complete,