What are the responsibilities and job description for the Patient Service Representative position at First Choice Community Health?

JOB TITLE : PATIENT SERVICES / CALL CENTER REPRESENTATIVE

EXEMPT : No DEPARTMENT : Billing / Administration

EMPLOYEE : REPORTS TO : Billing Manager

PREPARED BY : HR Coordinator DATE : 10 / 2008

APPROVED BY : CEO DATE : (rev) 11 / 2019

SUMMARY :

The Patient Service Representative (PSR) coordinates across patient care continuum by being the first and most frequent contact with patients, families, providers, and office staff. The PSR assists in coordination of healthcare and patient-centric care management by serving as patient and provider advocate by answering all specific questions, while educating and guiding patients through the complicated process of healthcare. The PSR also follows-up on calls by completing research, solving problems, and contacting various parties to implement solutions.

The PSR is a member of the Patient Centered Medical Home healthcare team approach to delivering care in a proactive, planned, and coordinated evidence-based care. The role of the PSR focuses on problem solving, patient advocacy, education and guidance by meeting the patient's needs and preferences for quality health care. The PSR will report to and receive supervision from the Billing Coordinator. As a PSR, employees will be expected to operate efficiently at either the Front Desk or Call Center.

Front Desk : responsible for check-in and check-out of all patients, insuring complete and accurate patient information, entering billing / encounter information into corporate practice management system accurately and timely, collecting co-payments, deductibles, etc. from patients, and collecting billing information for all payer types.
Call Center : responsible for handling high volume of incoming calls for FCCHC's appointment scheduling line; ensuring patients receive professional and courteous patient service as well as present information and answer questions regarding corporate patient scheduling and registration procedures.

ESSENTIAL DUTIES AND RESPONSIBILITIES :

They include, but are not limited to, the following :

Provide new and / or established patients with all forms that must to be completed or updated to ensure accurate patient demographic, insurance, financial (Sliding Fee Scale) and UDS information;

Ensure the completeness of forms, and accuracy of data obtained, are entered correctly into the corporate practice management systems; information will be updated each time patient comes into office to be seen;

Provide assistance to patients on any questions the patients may have pertaining to their form(s);

Resolved patient concerns in an effective and timely manner, to include re-routing calls;

Greet patients in a professional and courteous manner to ensure excellent patient service and satisfaction, which includes face-to-face and / or telephone communications and direct phone calls to the appropriate staff member;

Scheduling all patient appointments (to include follow-up visits) for individual location(s) in a timely manner and in accordance with corporate production goals;

Establish medical / dental records for all new patients;

Verify and obtain all information from the patient regarding demographic, insurance and financial (Sliding Fee Scale) is accurate and all copies of appropriate documentation to support demographic, insurance and financial information is filed in the patient's medical / dental record;

Responsible for making sure all the correct administrative and patient care forms are complete and filed in the appropriate order in the patient's medical / dental records;

When computer systems are down, retrieve patient medical record for patient visit and provide to the appropriate medical staff and re-file chart upon completion of visit and appropriate signatures have been received;

When computer systems are down, responsible for printing encounter form at check-in and entering all encounter charges and receipts immediately upon completion of the visit;

Run and balance corporate practice management system end of day receipt report totals between encounters, batch report (i.e., check conversion, cash and credit / debit card machine) and cash drawer. Run and balance corporate practice management system end of day charge report totals only when computer system is down;

Complete daily report form for appointments, production, charges, monies collected, batch report totals, drawer start off and petty cash along with corporate practice management system end of the day receipt report totals to Accounting at the close of each day;

Open mail and distribute mail following all U.S. Postal Service requirements and guidelines;

Assists in obtaining and maintaining NCQA PCMH recognition;

Faxing patient correspondence to outside entities from providers. This can include paper or electronic faxes depending on the type of fax;

Assist with purging of Medical and Dental records as directed;

Complete daily deposit slip(s);

Assist billing department in research and follow-ups;

Responsible for ordering office supplies and keeping work area clean and neat;

Performs other necessary duties as required by the health center to meet the goals of providing primary healthcare services.

QUALIFICATION REQUIREMENTS :

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and / or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

EDUCATION and / or EXPERIENCE :

GED or High School graduate with a minimum of two years of medical or dental clinic front desk operations experience.

LANGUAGE SKILLS :

Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence.

MATHEMATICAL SKILLS :

Ability to apply basic concepts of mathematics and computations.

REASONING ABILITY :

Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.

COMPETENCY / SKILLS REQUIREMENTS :

Competency required in the areas of communication, excellent verbal and written skills. Use of computer skills to include Microsoft Word and Excel.

CERTIFICATES, LICENSES, REGISTRATIONS :

None.

OTHER SKILLS AND ABILITIES :

Familiarity with effective use of computerized accounting / billing systems. Must be able to use other equipment such as a fax, copier, scanner, and calculator. Good organizational skills and the ability to perform numerous tasks simultaneously in a fast-paced office environment. Good analytical skills, sticker for details, sense of personal responsibility for work performance and a professional attitude. The ability to work without constant supervision and adhere to policies and procedures is a must.

PHYSICAL / MENTAL DEMANDS :

The physical / mental 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 disability to perform the essential functions.

While performing the duties of this job, the employee is regularly required to talk or hear, sit, and use hands to finger, handle, or feel objects, tools, or controls. The employee is occasionally required to stand, walk, climb, balance on two feet, stoop, kneel, crouch, or reach with hands and arms. The employee must occasionally lift and / or move up to 10 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.

Mental demands include the ability to learn, adapt to changes, pay close attention to details, exercise discretion and good judgment, develop options and solutions to crisis and problems, gather and analyze facts, courteous and professional behavior, deal with stressful situations and adhere to company policies and procedures.

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 noise level in the work environment is usually moderate.

RISK CLASSIFICATION LEVEL :

II - Job classification level in which employees have potential exposure to blood borne pathogens exists only when rendering minor first aid, which is a collateral function of the job.

I have read this job description and it has been discussed with me by my supervisor.

THIS JOB DESCRIPTION DOES NOT CONSTITUTE A CONTRACT FOR EMPLOYMENT.

EMPLOYEE SIGNATURE DATE

DEPARTMENT HEAD SIGNATURE DATE

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