Senior Patient Services Representative - Ophthalmology (Medical Center)

At Houston Methodist, the Senior Patient Services Representative is responsible for performing patient check in/check out functions and appointment scheduling to facilitate the patient visit experience. Responsibilities include performing more complex processes related to scheduling or other department related protocols and serving as a role model and mentor to less experienced staff. This position supports timely, accurate claims submission and may perform registration and/or other revenue cycle functions. Other duties include providing general operations assistance and/or patient service tasks specific to the scope of the department.

FLSA STATUS
Non-exempt

QUALIFICATIONS

EDUCATION

• High School diploma or equivalent education (examples include: GED, verification of homeschool equivalency, partial or full completion of post-secondary education, etc.)

EXPERIENCE

• Five years of experience to include three years experience in a related role within healthcare

SKILLS AND ABILITIES

• Demonstrates the skills and competencies necessary to safely perform the assigned job, determined through on-going skills, competency assessments, and performance evaluations
• Sufficient proficiency in speaking, reading, and writing the English language necessary to perform the essential functions of this job, especially with regard to activities impacting patient or employee safety or security
• Ability to effectively communicate with patients, physicians, family members and co-workers in a manner consistent with a customer service focus and application of positive language principles
• Strong customer service, phone and scheduling skills
• Basic computer skills in word processing applications and ability to utilize software systems such as the electronic medical record
• Knowledge of basic medical terminology
• Ability to analyze and solve problems
• Working knowledge of revenue cycle components and insurance requirements for reimbursement

ESSENTIAL FUNCTIONS

PEOPLE ESSENTIAL FUNCTIONS

• Contributes to a positive work environment and to a dynamic, team focused work unit that actively helps one another to achieve optimal department results. Collaborates with all members of the interprofessional health care team by actively communicating and reporting pertinent patient care information and data in a comprehensive manner.
• Performs patient check in/check out functions. Obtains and inputs accurate scheduling and registration data to initiate financial clearance activities as needed. Performs more complex processes related to scheduling or other clinic related protocols.
• Coordinates patient flow as directed with consistency, timeliness, and expert skill while meeting appropriate priority standards. Provides appropriate notification of issues that may result in service delays or denials. Handles add-ons, reschedules, and cancellations appropriately and as per department protocol.
• Functions as a role model and mentor for less experienced staff and serves as the next level resolution source for problems.

SERVICE ESSENTIAL FUNCTIONS

• Uses excellent communication skills (verbal, non-verbal, written) to facilitate providing the highest quality service during every patient, physician, guest, employee, or other encounter. Responds promptly to requests by staff, patients, physicians, and other members of the patient care team. Recognizes and responds appropriately to urgent/emergent situations per protocols.
• Contributes to patient, employee and physician satisfaction as well as effective revenue cycle process.
• Generates reports and assists with department correspondence. Provides other administrative assistance as directed.

QUALITY/SAFETY ESSENTIAL FUNCTIONS

• Serves as a liaison for the patient, medical staff, and third parties. Communicates to resolve patient access and quality service matters. Keeps open channels of communication with physician, patient, and service areas regarding action taken and resolution.
• Enters patient and operational data into various database systems with a high level of thoroughness, accuracy and timeliness.
• Ensures patient information is conveyed to others appropriately while complying with patient confidentiality and HIPAA regulations. May assist clinical staff as per scope of the treatment center.

FINANCE ESSENTIAL FUNCTIONS

• Accurately records information when performing functions such as charge entry, registration, scheduling, insurance verification/coordination, or obtaining authorizations or referrals to ensure financial objectives are met. Conducts front end revenue cycle duties as directed. Educates patients and others regarding billing processes and potential financial responsibilities as necessary.
• Organizes time effectively, minimizing incidental overtime, and sets priorities. Utilizes time between heavy workloads efficiently and helps other team members.
• Uses department resources/equipment/supplies properly and efficiently. Participates in inventory management by taking action to ensure supply levels are adequate.

GROWTH/INNOVATION ESSENTIAL FUNCTIONS

• Displays initiative to improve job functions; offers suggestions to streamline process for efficient patient flow and other quality or service matters.
• Seeks opportunities to expand learning beyond baseline competencies with a focus on continual development.

SUPPLEMENTAL REQUIREMENTS
WORK ATTIRE

• Uniform: No
• Scrubs: No
• Business professional: Yes
• Other (department approved): No

ON-CALL*
*Note that employees may be required to be on-call during emergencies (ie. Disaster, Severe Weather Events, etc) regardless of selection below.

• On Call* No

TRAVEL**
**Travel specifications may vary by department**

• May require travel within the Houston Metropolitan area No
• May require travel outside Houston Metropolitan area No

QUALIFICATIONS

EDUCATION

• High School diploma or equivalent education (examples include: GED, verification of homeschool equivalency, partial or full completion of post-secondary education, etc.)

EXPERIENCE

• Five years of experience to include three years experience in a related role within healthcare