Patient Service Representative
Job Title: Patient Service Representative (Medical or Dental)
Reports To: Health Center Administrator or Mobile Medical Program Administrator
Job Summary: Assists Patients, Lead Patient Service Representative, and the Health Center Management (HCM) team in the performance of a broad range of administrative duties.
Qualifications and Requirements:
To perform this job successfully, an individual must be able to perform each essential job duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.
Essential Job Duties:
- Clinical Administrative Duties.
- Schedules and confirms patient appointments.
- Provides and facilitates the completion of necessary patient forms.
- Verifies medical or dental insurance coverage and eligibility.
- Assists patients with presumptive applications for Sliding Fee Discount Program.
- Verifies patient demographic information.
- Informs patients of account balances and takes payments over the counter.
- Answers telephone calls. Responds to caller questions as able and/or transfers calls to appropriate party.
- Takes and documents messages as appropriate.
- Deciphers the correct amount to charge self-pay, prompt pay or sliding fee discount program for patients.
- Proactively greets, interacts with, and assists patients and staff in a professional manner.
- Checks in patients on location.
- Travels to any location as needed.
- Performs medical records scanning and other lead duties if hired at a center with no lead PSR. Will be designated by HCA.
- Working assigned weekends is required.
- 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.
- Proactively calls patients from recall plan reports and schedules patients’ appointments according to recall.
- Verifies patient treatment plans, patient instructions, and summary reports.
- Verifies dental deductible.
- 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.
- Runs queries on Cenpatico patients and determines which patients are missing quality measures.
- Calls patients that are missing quality measures to schedule appointments.
- 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 Mobile Medical Units.
- Ensures accuracy of provider schedules.
- Verifies provider un-submitted encounters, as necessary.
- Verifies chart guard access and prints documents as needed.
- Performs medical records scanning.
- Provides Staff Meeting minutes.
- Print out new patient letters as requested.
- Posts payments and facilitates bank deposits.
- Runs encounter co-pay report as requested.
- Runs and acts on reports as requested.
- Maintains cleanliness of the mobile medical units, discards trash.
Required Education, Experience, Certificates & Licenses:
- High School Diploma or GED.
- Six months of experience in a customer service or office support.
- Any combination of experience and/or education that provides the necessary skills.
- 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 may be required.
Preferred Education, Experience, Certificates & Licenses:
- 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.
- Knowledge of Electronic Health Records preferred.
- 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.