Patient Service Representative
Job Title: Patient Service Representative (Medical or Dental)
Reports To: Health Center Administrator, Mobile Medical Program Administrator, or PSR Supervisor
Job Summary: Conducts multiple administrative functions while achieving the following: maintaining optimal center/department productivity while transcribing accurate patient demographic information into the required systems to ensure timely reimbursement of visits, while providing excellent customer service to all external and internal customer.
Essential Job Duties and Responsibilities:
The job duties and responsibilities listed below are representative of the knowledge, skill, and/or ability required. Other duties that fall within the broad scope of this classification may be assigned.
- Maintains Optimal Center/Department Productivity
- Proactively schedules patient appointments.
- Confirms patient appointments as needed.
- Checks in patients on location.
- Works assigned early mornings, late evenings and weekends as required.
- Work in remote areas of Cochise County as required.
- Transcribe Accurate Patient Demographic Information into the Required Systems to Ensure Timely Reimbursement of Visits
- Verifies medical or dental insurance coverage and eligibility.
- Verifies patient demographic information.
- Informs patients of encounter co-pays, deductibles, account balances and takes payments over the counter at the time of visit.
- Deciphers the correct amount to charge self-pay, prompt pay or sliding fee discount program for patients.
- Performs medical records scanning.
- Provides Excellent Customer Service
- Provides and facilitates the completion of necessary patient forms.
- Assists patients with presumptive applications for Sliding Fee Discount Program.
- Answers telephone calls. Responds to caller questions as able and/or transfers calls to appropriate party.
- Takes and documents messages as appropriate.
- Proactively greets, interacts with, and assists patients and staff in a professional manner.
- Travels to any location as needed.
- Clean lobby, restrooms and other patient areas with proper cleaning supplies while using proper Personal Protective Equipment (PPE).
- Screen all patients and visitors and perform Infrared and ear temperature checks.
- Use and educate patients and visitors on the proper Personal Protective Equipment (PPE) as required.
- Additional Dental Administrative Duties
- Place all necessary recall plans for patients.
- Verifies patient treatment plans, patient instructions, and summary reports.
- Processes and assists in the completion of dental referrals and tracking.
- Follows up on all outside referrals for the patient.
- Performs and assists in the completion of prior insurance authorizations and tracking.
- Together with the patient, provider and/ or other members of the dental care team assists with estimates for treatment plans for the patient and reviews with patients.
- Additional Administrative Duties if Assigned to SEABHS Clinic
- Runs queries on Cenpatico patients and determines which patients are missing quality measures.
- Assists patients in overcoming barriers to care by scheduling follow-up appointments, arranging transportation, and following up with patients who missed appointments.
- Performs other duties and special projects for the quality department as assigned.
- Additional Administrative Duties if Assigned to a Center without a Lead PSR
- Ensures accuracy of provider schedules.
- Verifies provider un-submitted encounters, as necessary.
- Verifies chart guard access and prints documents as needed.
- Provides Staff Meeting minutes.
- Print out new patient letters as requested.
- Post’s payments and facilitates bank deposits.
- Runs encounter co-pay report as requested.
- Maintains cleanliness of the mobile medical units, discards trash.
Minimum Qualifications - Education, Experience, Certificates & Licenses:
- High School Diploma or GED.
- Six months of experience in a customer service or office support required.
- Any combination of experience and/or education that provides the necessary skills and sensitivity.
- Driver's License and Proof of Insurance may be required if requesting mileage reimbursement. For Float positions, mileage may not be paid.
- Valid Fingerprint Clearance Card.
- Experience in a healthcare setting preferred.
Required Language Skills:
- Ability to comprehend and compose instructions, correspondence, and communications in English in both oral and written format.
- Bilingual in English and Spanish may be required based on current staffing patterns, patient population, and/or duty assignment.
- Ability to comprehend and understand limited medical terminology.
- Ability to occasionally exert enough force to move objects weighing up to 10 pounds.
- Ability to continuously remain in a stationary position.
- Ability to constantly move about inside the workplace to assist patients, access files, and operate office or medical equipment, etc.
- Possesses hand-eye coordination and manual dexterity necessary to constantly operate computer, telephone, and other office machinery.
- Possesses close visual acuity necessary to accurately record and view information on a computer monitor, handwritten and typed documents.
- Ability to discern the nature of sounds at a normal spoken volume.
Other Required Knowledge, Skills, and Abilities:
- Ability to add, subtract, multiply and divide in all measure, using whole numbers, common fractions, and decimals.
- Ability to compute rate, ratio, and percent.
- Ability to gather data in an organized fashion from varied sources.
- Ability to take direction and perform assignments accordingly.
- Ability to deal with challenges involving one or more variables in routine situations.
- Knowledge of prepaid health plans and community health centers preferred.
- Ability to comprehend and understand insurance co-pays.
- Knowledge of HIPAA rules and regulations.
- Computer literacy required.
- Ability to provide excellent customer service by mail, telephone, and in-person.
Work Environment & Conditions:
- Work environment is typical of a health clinic setting with occasional exposure to communicable diseases, bodily fluids, and hazardous chemicals.
- Work requires reliable transportation as position requires occasional travel and extended hours to include early mornings, evenings, holidays, and weekends.
- If hired for a float position, position requires frequent travel to any health center as needed.