Patient Service Representative

Major Responsibilities

• Patient Services: Provides efficient, high-quality service to patients who arrive for appointments or who telephone or visit in person to request appointments or information on tests and procedures, bills and charges, referrals, and other matters.

1. Greets and accurately registers patients in EMR system verifying essential billing and demographic information.
2. Coordinates scheduling of patient appointments (phone and in-person requests) accurately and efficiently.
3. Answers multiple incoming telephone lines, accurately determining the appropriate recipient of the call or message and referring them promptly and appropriately.
4. Distributes communications accurately, based on practice protocol. Includes pagers, faxes, emails.
5. Resolves a variety of patient questions, including HMO referrals, billing and queries about services and test results; refers complex issues to practice manager or a clinical staff member, as appropriate.
6. Schedules future appointments and requisitions, laboratory tests, radiology procedures and other special diagnostic tests as needed. May coordinate with appropriate sections of hospital admission and/or outpatient admissions and surgery.
7. Notifies patient care area when patient has arrived and is ready to be seen. Attends to waiting patients in reception and ensures that they are seen in a timely manner or are promptly notified of unexpected delays.
8. Accurately identifies type of insurance from card, understands different types of payers, and verifies eligibility if necessary.
9. Performs other related duties as required.

• Billing Services: Ensures the collection of maximum possible fees at the time of service and accurate follow-up billing information on the patient and payer.

1. Reviews encounter forms for accuracy and completeness, checks with physician for missing information.
2. Enters patient charges into the EMR system according to established policies and procedures.
3. Batches encounter forms and balances charges.

• Medical Record Services: Upholds standards of the practice and of the medical group for accurate and timely medical records.

1. Ensures the availability of properly prepared patient medical records, daily schedules and related forms. Maintains medical record including loose filing and re-filing of charts daily. Pull and prepares charts for appointments.
2. Maintains confidentiality around all patient information, both in front of each patient being treated and around other patients in the area.
3. Releases information from records, only according to corporate policies and procedures.

Education/Experience Required

• High school diploma or equivalent.
• One to two years related customer service experience
• Experience handling difficult caller/customers/patients.

Knowledge, Skills & Abilities Required

• CRT/PC experience in a customer service setting.
• Working knowledge of eClinicalWorks and scheduling sections of the eClinicalWorks system preferred.
• Strong communication skills.
• Ability to solve problems posed by callers seeking referrals, appointments, billing issues and clinical information.

Physical Requirements and Working Conditions

• Ability to function in a high volume, multiple-task environment, possibly in a crowded or closely shared workspace.
• Exposure to ill patients.
• Ability to work under stressful conditions with demanding customers.
• Ability to lift up to 35 pounds without assistance. For patient lifts of over 35 pounds, or when patient is unable to assist with the lift, patient handling equipment is expected to be used, with at least one other associate, when available. Unique patient lifting/movement situations will be assessed on a case-by-case basis.

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.