Patient Service Representative II

Description

The Patient Service Representative (PSR) II is part of the Codman Square Health Center Float Pool. This position is based in the clinical area, however can be deployed to support other areas. The PSR II reports to that clinic’s Practice Supervisor or Administrator.

The PSR II is responsible for performing tasks that directly support Health Center’s front-end revenue cycle management functions, including Patient Service Center and clinic administrative processes. The PSR II is required to provide excellent customer service for patients, staff and providers alike – whether on the phone or during face-to-face interactions, and to ensure a positive patient experience for Codman Square Health Center’s patients and their families.

The PSR II is responsible for providing first call resolution and all other tasks required of the Patient Service Center or the clinical area depending on the area s/he is deployed.  S/He will handle patient inquiries, following-up with patients resolving patient questions/concerns regarding insurance verification and authorization management.

The PSR II must have solid knowledge of medical insurance terminology, the federal poverty guidelines and the Health Center’s sliding fee discount policy and procedures. The PSR II is required to maintain a solid understanding of each clinic’s administrative requirements and guidelines. The specific tasks and duties will vary based on where within the Health Center the PSR II is deployed. 

S/he must have excellent verbal and written communication skills, as well as the ability to effectively prioritize and manage their work and assist colleagues to ensure all required administrative tasks and patient inquiries are handled in a timely manner.

All PSR II staff will be trained on the Codman Square Health Center’s specific requirements and workflows and expected to adhere to all standards and protocols.

Qualifications

JOB SPECIFIC DUTIES AND RESPONSIBILITIES:

• Responsible for welcoming all patients by smiling and establishing eye contact with patients.
• Responsible for monitoring the waiting rooms, coordinate with clinical staff to notify patients of any delays.
• Responsible for performing patient Check In functions, incl. registration, insurance verification, collecting required co-pays or other payments, administering the sliding scale discount program, and ‘arriving’ patients for their appointments in the Electronic Health Record (EHR).
• Responsible for explaining to patients/parents/guardians their responsibilities ( i.e. arrival and appointment times, form requirements, payment expectations, late and cancellation policy)
• Responsible for entering accurate patient data, telephone encounters, referrals, forms and prescription requests into the EHR.
• Responsible for assisting patients with completing / collecting pre-visit, consent and other forms; processing patient forms, letters or obtaining prescription request information from patients.
• Responsible for assisting patients with appointment scheduling – whether within or across Codman Square Health Center departments.
• Responsible for promoting Patient Portal.
• Responsible for performing patient Check Out, incl. scheduling follow up appointments, specialist appointments, assisting and educating patients on referral process.
• Responsible for performing patient pre-registration.
• Responsible for scheduling same day and follow up appointments, conducting appointment reminder calls, putting patients on recall list, processing patient no shows and cancellations, and performing end of day reconciliations.
• Responsible for coordinating transfer of patients from clinics and Urgent Care.
• Responsible for effectively managing in basket patient related messages in timely manner.
• Must use sound judgment to determine when and to whom to escalate issues to ensure resolution.
• Must adhere to HIPAA and protect the confidentiality and sensitivity of patient information.
• Must meet service level expectations and identified key performance indicators.
• Must meet or exceed call volume, pre-registration and insurance verification productivity and accuracy expectations.
• Ensure workstation, patient waiting room and common areas are kept clean.
• Required to follow standard operating policies and procedures, while delivering expedient professional responses to patients’ inquires and concerns.
• Responsible for facilitating communication with Clinics.
• Must attend staff meetings, as needed.

• Must attend and assist with staff training, when needed.
• Must serve as an EHR Super User and provide support and training to co-workers, upon request.
• Assist with handling escalated issues

• Assist with performing quality assurance reviews.
• Responsible for coordination with enrollment and financial counseling \
• Assists in the training/orientation of new personnel under the direction of a manager and/or supervisor.
• Other duties as assigned

EDUCATION REQUIREMENTS

• Associate Degree preferred, High school diploma required.
• A minimum of three years’ experience in n a medical/clinical office environment or Health or Dental insurance industry required.
• Previous customer service background required.
• Bilingual ability a plus.

SKILLS / ABILITIES / COMPETENCIES REQUIRED

• Excellent customer service and interpersonal skills.  
• Ability to interact with diverse patient population
• Solid computer literacy; ability to multitask, organize and prioritize one’s own work.
• Solid understanding of medical insurance terminology.
• Previous experience and knowledge of Community Health Center or Hospital patient registration systems, insurance eligibility verification systems (i.e. MMIS, WebMD, Trizetto, NEHEN).
• Solid knowledge of insurance plans, concepts and terms.
• Expected to stay abreast of scheduling rules, health care insurance changes and referral requirements.
• Ability to quickly learn new systems and tasks; work as a team member and independently.
• Ability to work in a fast pace environment.
• Ability to listen well and devote full attention to patients and medical professionals alike.
• Ability to be compassionate, caring, and to remain calm, even under the most stressful of situations.
• Flexibility with schedule is required - upon request may be required to work extended hours or cover evening and weekend sessions.