Patient Service Representative: Pediatrics - Springer Building - Warren Clinic

Job Summary: Performs reception, registration and billing functions in the front office of the Medical Practice to facilitate the effective delivery of patient care.

Minimum Education: High School Diploma or GED.

Licensure, Registration and/or Certification: None.

Work Experience: One (1) year experience.

Knowledge, Skills and Abilities: Demonstrated PC skills. Effective organization of multi-task role. Understanding of healthcare delivery and billing processes in the medical office. Ability to accurately record and interpret data. Effective interpersonal, written and oral communication skills. Ability to organize and prioritize work in an effective and efficient manner.

Essential Functions and Responsibilities: Maintains exemplary patient satisfaction and participates as an engaged team member. Greets and directs patients and visitors according to established office protocols. Informs patients of delays in care. Communicates schedule changes to physicians, clinical assistants and other staff as appropriate. Maintains and corrects environment for cleanliness and safety. Schedules appointments, registers demographic and billing information, determines eligibility to accommodate patient's care in the medical office. Successfully uses the EMR and other computer applications to accomplish tasks according to policies and procedures. Maintains medical records including preparation of charts, filing of correspondence and test results. Prepares encounter forms and other supporting billing documentation. Maintains and distributes provider schedules including application of templates, hold times, etc. Determines and collects co-pays and deductibles from patients. Requests payments of self pay balances according to policies. Responsible for preparation of cash receipts, bank deposits and balancing of cash drawer on a daily basis. Converts provider written description of diagnosis to appropriate ICD-9 code. Posts charges and payments to patient accounts. Reviews and corrects rejected or denied claims. Reviews and assists in collections of past due accounts. Prepares phone notes for communication to the provider from patients, pharmacists, and other healthcare sources. Makes calls to patients to remind them of pending appointments or communication from provider. Distributes mail and other communication to patients, providers and staff. Determines eligibility and obtains authorization for services. Schedules tests and appointments for referred services. Tracks referrals made for specified services. Participates in quality initiatives and safety functions. Assists in identifying and ordering needed supplies. Remains informed and compliant with current Health System, Warren Clinic, HIPAA and OSHA policies and procedures.
Decision Making: Independent judgment in planning the sequence of operations and making decisions in a complex technical or professional field.

Working Relationships: Works directly with patients and/or customers. Works with internal / external customers. Works with other healthcare professionals and staff. Works frequently with individuals at director level or above.

Special Job Dimensions: None.

Supplemental Information: This document generally describes the essential functions of the job and the physical demands required to perform the job. This compilation of essential functions and physical demands is not all inclusive nor does it prohibit the assignment of additional duties.

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