What are the responsibilities and job description for the Outpatient Operations-Lead Patient Services Representative position at Children's Hospital of Philadelphia?
SHIFT:
Day (United States of America)
Seeking Breakthrough Makers
Children’s Hospital of Philadelphia (CHOP) offers countless ways to change lives. Our diverse community of more than 20,000 Breakthrough Makers will inspire you to pursue passions, develop expertise, and drive innovation.
At CHOP, your experience is valued; your voice is heard; and your contributions make a difference for patients and families. Join us as we build on our promise to advance pediatric care—and your career.
CHOP’s Commitment to Diversity, Equity, and Inclusion
CHOP is committed to building an inclusive culture where employees feel a sense of belonging, connection, and community within their workplace. We are a team dedicated to fostering an environment that allows for all to be their authentic selves. We are focused on attracting, cultivating, and retaining diverse talent who can help us deliver on our mission to be a world leader in the advancement of healthcare for children.
We strongly encourage all candidates of diverse backgrounds and lived experiences to apply.
A Brief Overview
The Lead PSR is responsible for supervisor coverage and leadership for the Patient Service Representatives and other operational staff. The Lead PSR assures staff adherence to all enterprise policies and procedures that have been developed to ensure effective and efficient quality service to patients and families. This role is responsible for supervising and covering for all functions related to greeting patients and families, scheduling, registration, collecting, entering and verifying insurance information, answering phones, obtaining/validating insurance referrals and authorizations as needed per insurance guidelines, cash collections and reconciliation, insurance verification and financial counseling. Responsibilities may include working with medical records, following HIPAA guidelines, oversee appointment confirmation, review/approve time off and perform payroll functions, and process reimbursements and credentialing packets. Other duties and administrative support and projects as required.
What You Will Do
Employees may request exemptions for valid religious and medical reasons. Start dates may be delayed until candidates are immunized or exemption requests are reviewed.
EEO / VEVRAA Federal Contractor | Tobacco Statement
Day (United States of America)
Seeking Breakthrough Makers
Children’s Hospital of Philadelphia (CHOP) offers countless ways to change lives. Our diverse community of more than 20,000 Breakthrough Makers will inspire you to pursue passions, develop expertise, and drive innovation.
At CHOP, your experience is valued; your voice is heard; and your contributions make a difference for patients and families. Join us as we build on our promise to advance pediatric care—and your career.
CHOP’s Commitment to Diversity, Equity, and Inclusion
CHOP is committed to building an inclusive culture where employees feel a sense of belonging, connection, and community within their workplace. We are a team dedicated to fostering an environment that allows for all to be their authentic selves. We are focused on attracting, cultivating, and retaining diverse talent who can help us deliver on our mission to be a world leader in the advancement of healthcare for children.
We strongly encourage all candidates of diverse backgrounds and lived experiences to apply.
A Brief Overview
The Lead PSR is responsible for supervisor coverage and leadership for the Patient Service Representatives and other operational staff. The Lead PSR assures staff adherence to all enterprise policies and procedures that have been developed to ensure effective and efficient quality service to patients and families. This role is responsible for supervising and covering for all functions related to greeting patients and families, scheduling, registration, collecting, entering and verifying insurance information, answering phones, obtaining/validating insurance referrals and authorizations as needed per insurance guidelines, cash collections and reconciliation, insurance verification and financial counseling. Responsibilities may include working with medical records, following HIPAA guidelines, oversee appointment confirmation, review/approve time off and perform payroll functions, and process reimbursements and credentialing packets. Other duties and administrative support and projects as required.
What You Will Do
- Provide welcoming, prompt and respectful customer service which includes scheduling appointments, inform of delays, address family complaints and escalate as necessary.
- Oversee appointment confirmation and enter diagnosis codes according to pre-established practice guidelines.
- Perform EPIC functions such as check in, check out, enter demographic and insurance information while ensuring accuracy, run daily eligibility verifications, enter and make daily edits to provider EPIC templates.
- Answer phones promptly with minimal downtime between calls, accurately verifies and documents contact information and messages, provide appropriate information to callers as warranted. Communicate in a courteous, caring manner to all customers as needed. Check voicemails.
- Perform administrative tasks such as sort and deliver mail, faxes, medical records and other correspondence; photocopies and faxed documents. Oversee/order office supplies.
- Lead and facilitate team huddles and meetings.
- Reconciliation of daily services to include collection and processing of payments received, reimbursements, create and/or obtain insurance referrals and authorizations needed.
- Daily maintenance of patient records following HIPAA guidelines.
- Enter provider templates and make daily edits as needed to provider schedules.
- Coordinate daily eligibility verifications, reconcile drawers and make cash deposits, order supplies and other clerical duties as assigned.
- Supervise staff, maintain PSR staff schedules, supervise day to day activities and participate in interviews and PSR evaluations, oversee PSR onboarding process, provide ongoing training and coaching, organize and lead PSR meetings, assist Supervisor(s) with productivity, and office/departmental coverage.
- Other areas of responsibility may include, payroll edit functions, answer billing inquiries, work/oversee necessary billing ques, attending billing meetings, process credentialing packets, attend and participate in monthly PL meetings. Work various appointment recall, waitlists, value-based care and other reports. Complete After Hours Program Physician on-call schedule as needed.
- Additional patient support duties may include: Respond to all traumas, resuscitations and codes, coordinate with Social Work, Nursing, and Case Managers to assist w/ newborn coverage. Emergency, Sitter and Admissions duties as needed.
- If located in an area where 24/7 coverage is needed, will need to rotate shifts.
- ED/Admissions specific tasks as assigned include: SART paperwork processing, Nurse Call communications, Trauma B-line and arrivals.
- High School Diploma / GED Required
- At least three (3) years patient services representative experience in a role that consisted of health care, registration, physician billing, medical records, medical office work and relatable customer service. Required
- At least three (3) years of Epic experience Preferred
- A strong background in Epic Preferred
- A strong background with MS Office Suites Preferred
- A strong background in customer services PreferredAt least one (1) year experience of leadership experience Preferred
- Basic knowledge of medical and billing terminology. Solid conflict resolution skills.
- Basic knowledge HIPAA regulations.
- Intermediate proficiency with electronic medical record software preferred.
- Intermediate proficiency with Microsoft Suite.
- Excellent verbal and written communications skills.
- Excellent interpersonal skills.
- Excellent organizational skills.
- Strong time management skills.
- Ability to maintain confidentiality and professionalism.
- Ability to work independently with minimal supervision.
- Ability to work with and relate to people at all levels.
Employees may request exemptions for valid religious and medical reasons. Start dates may be delayed until candidates are immunized or exemption requests are reviewed.
EEO / VEVRAA Federal Contractor | Tobacco Statement
