Patient Services Representative

Description

Work Schedule: M, T & Th: 11:00am-7:00pm; W & F: 9:30am-5:30pm. Sat. as needed

Position Overview:

The Patient Services Representative handles all aspects of front office functions utilizing E-Clinical Works, the Center’s Practice Management System; including but not limited to scanning of patient documents.  Will be assigned, or a rotating basis or when the need arises, to perform various data entry functions at different units. This work is carried out in support of the mission and goals of Ryan Health.

Essential Functions:

1.    Check in patient’s visit

• create Walk-In visit, when necessary.

2.    Collect the appropriate fee from self-pay, uninsured patients, as necessary.

3.    Verify patient insurance using the appropriate equipment and bill patient’s insurance for services.

• add Managed Care Insurance carrier, as necessary

• collect the appropriate insurance co-pay

• ensure that authorization for services is maintained appropriately, before processing patient’s visit

4.    Collect patient balances, and refer patients with delinquent accounts or who express payment difficulty, to the Supervisor or designee.

5.    Wherever possible, make the necessary corrections, prior to checking-in patient’s visit when computer information is incorrect or must be updated.

6.    Provide patient with payment receipt, as appropriate.

7.    Balance patient revenue collected for bank deposit.

8.    Direct patients to the appropriate service area.

9.    Register patients by completing appropriate computer screens with appropriate patient information.

• Screen prospective patients for eligibility based on Ryan/Chelsea-Clinton Community Health Center, and federal guidelines.
• Interview patients to capture required family and financial information.
• Orient patients to services and procedures of the Ryan/Chelsea-Clinton Community Health Center, including but not limited to; hours, fees, scheduling and canceling appointments, Patient Rights, Board of Directors: assure that patient is given correct and complete information, and   
• fully understands this information.

• Inform eligible patients on the assistance available for entitlements, including but not limited to Medicaid, Managed Care Plans accepted at the Center, ADAP, Presumptive Eligibility Program (formerly known as PCAP) and refer them to the appropriate staff, when required.
• Ensure that patient and/or the legal guardian signs the Consent for Treatment and Release of Information upon initial registration.
• Scan appropriate documents into the patient’s file.
• Ensure that patient signs appropriate screen forms.
• Use appropriate equipment to capture patient photo, when authorized by the patient.

10.  Update (recertify) patient registration information, as necessary or when patient reports a change, including but not limited to income, insurance, address, telephone, number of dependents, etc.

11.  Distribute and secure patient and/or legal guardian signature regarding HIPAA, as required by law.

12.  Distribute and explain Patient Information Packet and answer patient questions.

13.  When appropriate, refer patients to appropriate Ryan/Chelsea-Clinton Community Health Center departments and community or social agencies.

14.  Schedule appointments as requested by patients and/or providers:

• Check-out patients after booking all appointments, including labs, so that Center scheduling reports are accurately maintained.
• Ensure that Telephone Encounter Appointment requests are processed efficiently and appropriately; when unable to immediately schedule an appointment, inform the provider and maintain the appropriate information, in order to call the patient back to schedule the appointment.

15.  Forward referral requests to the Referrals Department ensuring all Laboratory, X-Ray Reports, pertinent medical information and medication list are updated as needed.

• Schedule Urgent/STAT and non-St. Luke’s/Roosevelt Hospital referrals once returned.
• Ensure all pertinent information indicated on all referral requests including specialty, diagnosis, and tentative location.
• Ensure any Self-schedule appointments have at least location or phone number of tentative location to allow for appropriate follow-up plan of care.
• All comments regarding communication with and from the patient must be time stamped in the “Notes” tab under Specialty Referrals.
• All diagnostic referrals must be time stamped with the appointment date and time in the “Notes” section of Diagnostic referrals.

16.  Review practitioner schedules and mark No Show appointments:

• before printing address label, ensure information is accurate
• print and mail No Show letter to patient
• save “No Show” letter in patient’s electronic file

17.  Cancel and reschedule appointments at:

• Patient’s request
  • Indicate “Rescheduled” in old Visit Status field of original appointment
  • Mail new appointment to patient if requested
• Supervisor’s request
  • Prepare and process cancellation/rescheduling appointments and letter to patients.
  • When necessary, call patients to cancel and/or reschedule appointments.
  • Verify patient address/telephone number for Certified Mail.

18.  Consult with provider and/or authorized staff when a provider’s schedule must be overridden.

19.  Process Appointment Phone Reminder calls.

20.  Correctly route calls received to the appropriate personnel by:

• Dialing desired extension

• The use of the Workstation’s Personnel Directory
• Faxing and efaxing documents

21.  Use Paging System when requested by Director or other authorized staff.

22.  Keep Director or designee informed on problems with Telephone Workstation.

• Report equipment problems to Director or designee.

23.  Greet patients in a pleasant and courteous manner.

• verify patient identity by established two-patient identifier, when computer photo is not part of the patient computer record.

24.  Ensure to review Billing/Global Alerts, before processing patient.

25.  Speak and perform duties courteously, tactfully and confidentially with patients and staff.

26.  Immediately report any problems or unusual occurrences to supervisor.

27.  Must demonstrate a professional, courteous and respectful attitude in dealing with patients, immediate supervisor and other employees.

28.  Must demonstrate the knowledge and skills necessary to provide care appropriate to the age of the patient served.

29.  Operate various office equipment, including, but not limited to Xerox, credit card machine, scanner, label maker, stamp machine, faxes, efaxes  and insurance web sites.

Qualifications

Minimum Qualifications:

• High School Diploma or GED required.
• Experience with front office practice management, including corrections, deletion and control techniques and knowledge of Electronic Health Record system(s).
• Must enjoy working with the public, and be able to respect patient confidentiality at all times.
• Excellent verbal skills necessary.

Preferred Qualifications:

• Experience in Community or Human Services Agency desired.
• Bilingual: English/Spanish.
   

Competencies Required:
Customer Service: 

• Professional, courteous and respectful attitude in dealing with patients
• Demonstrate the knowledge and skills necessary to provide care appropriate to the age of the patient served (if applicable).
• Commits to exceeding expectations of the patient

Cooperation/Teamwork

• Works well with others
• Contributes input to improve outcomes
• Asks others for opinions and feedback, provides feedback in a tactful respectful way

Minimal Training Time:

Three months of actual workdays’ probationary period.

Working Conditions:
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 frequently required to stand, sit, talk and hear.

The employee is occasionally required to move about the office; use hands and fingers to feel, handle, or operate office equipment.

Specific vision abilities required by this job include close vision and the 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 work is primarily in a general primary care setting, which includes the unpredictability in behaviors of individuals, and acute and chronic infectious diseases, which may be contagious.  Adequate preparation and precaution is necessary. 

Disclaimer

The duties listed above are intended only as illustrations of the various types of work that may be performed. The omission of specific statements of duties does not exclude them from the position if the work is similar, related or a logical assignment to the position.  This position may be required to perform other duties.  If such work becomes a permanent and regular part of the job, a new description will be prepared. 

Equal Opportunity Employer

Ryan Health is an Equal Opportunity Employer and does not discriminate on the basis of age, color, disability, ethnicity, marital or family status, national origin, race, religion, sex, sexual orientation, gender identity, military veteran status, or any other characteristic protected by law.