Patient Service Representative (Medical or Dental)

Job Description

Reports To: Health Center Administrator or Mobile Medical Program Administrator

Job Summary: Assists Patients, Lead Patient Service Representative, and the Health Center Management (HCM) team in the performance of a broad range of administrative duties.

Qualifications and Requirements:

To perform this job successfully, an individual must be able to perform each essential job duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.

Essential Job Duties:

• Clinical Administrative Duties.
• Schedules and confirms patient appointments.
• Provides and facilitates the completion of necessary patient forms.
• Verifies medical or dental insurance coverage and eligibility.
• Assists patients with presumptive applications for Sliding Fee Discount Program.
• Verifies patient demographic information.
• Informs patients of account balances and takes payments over the counter.
• Answers telephone calls. Responds to caller questions as able and/or transfers calls to appropriate party.
• Takes and documents messages as appropriate.
• Deciphers the correct amount to charge self-pay, prompt pay or sliding fee discount program for patients.
• Proactively greets, interacts with, and assists patients and staff in a professional manner.
• Checks in patients on location.
• Travels to any location as needed.
• Performs medical records scanning and other lead duties if hired at a center with no lead PSR. Will be designated by HCA.
• Working assigned weekends is required.
• Clean lobby, restrooms, and other patient areas with proper cleaning supplies while using proper Personal Protective Equipment (PPE).
• Screen all patients and visitors and perform Infrared and ear temperature checks.
• Use and educate patients and visitors on the proper Personal Protective Equipment (PPE) as required.
• Additional Dental Administrative Duties.
• Place all necessary recall plans for patients.
• Proactively calls patients from recall plan reports and schedules patients'' appointments according to recall.
• Verifies patient treatment plans, patient instructions, and summary reports.
• Verifies dental deductible.
• Processes and assists in the completion of dental referrals and tracking.
• Follows up on all outside referrals for the patient.
• Performs and assists in the completion of prior insurance authorizations and tracking.
• Together with the patient, provider and/ or other members of the dental care team assists with estimates for treatment plans for the patient and reviews with patients.
• Additional Administrative Duties if Assigned to SEABHS.
• Runs queries on Cenpatico patients and determines which patients are missing quality measures.
• Calls patients that are missing quality measures to schedule appointments.
• Assists patients in overcoming barriers to care by scheduling follow-up appointments, arranging transportation, and following up with patients who missed appointments.
• Performs other duties and special projects for the quality department as assigned.

Additional Administrative Duties if Assigned to Mobile Medical Units.

• Ensures accuracy of provider schedules.
• Verifies provider un-submitted encounters, as necessary.
• Verifies chart guard access and prints documents as needed.
• Performs medical records scanning.
• Provides Staff Meeting minutes.
• Print out new patient letters as requested.
• Posts payments and facilitates bank deposits.
• Runs encounter co-pay report as requested.
• Runs and acts on reports as requested.
• Maintains cleanliness of the mobile medical units, discards trash.

Required Education, Experience, Certificates & Licenses:

• High School Diploma or GED.
• Six months of experience in a customer service or office support.
• Any combination of experience and/or education that provides the necessary skills.
• Driver''s License and Proof of Insurance may be required if requesting mileage reimbursement. For Float positions, mileage may not be paid.
• Valid Fingerprint Clearance Card may be required.

Preferred Education, Experience, Certificates & Licenses:

• Experience in a healthcare setting preferred.

Required Language Skills:

• Ability to comprehend and compose instructions, correspondence, and communications in English in both oral and written format.
• Bilingual in English and Spanish may be required based on current staffing patterns, patient population, and/or duty assignment.
• Ability to comprehend and understand limited medical terminology.

Physical Requirements:

• Ability to occasionally exert enough force to move objects weighing up to 10 pounds.
• Ability to continuously remain in a stationary position.
• Ability to constantly move about inside the workplace to assist patients, access files, and operate office or medical equipment, etc.
• Possesses hand-eye coordination and manual dexterity necessary to constantly operate computer, telephone, and other office machinery.
• Possesses close visual acuity necessary to accurately record and view information on a computer monitor, handwritten and typed documents.
• Ability to discern the nature of sounds at a normal spoken volume.

Other Required Knowledge, Skills, and Abilities:

• Ability to add, subtract, multiply, and divide in all measure, using whole numbers, common fractions, and decimals.
• Ability to compute rate, ratio, and percent.
• Ability to gather data in an organized fashion from varied sources.
• Ability to take direction and perform assignments accordingly.
• Ability to deal with challenges involving one or more variables in routine situations.
• Knowledge of prepaid health plans and community health centers preferred.
• Ability to comprehend and understand insurance co-pays.
• Knowledge of HIPAA rules and regulations.
• Computer literacy required.
• Knowledge of Electronic Health Records preferred.
• Ability to provide excellent customer service by mail, telephone, and in person.

Work Environment & Conditions:

• Work environment is typical of a health clinic setting with occasional exposure to communicable diseases, bodily fluids, and hazardous chemicals.
• Work requires reliable transportation as position requires occasional travel and extended hours to include early mornings, evenings, holidays, and weekends.
• If hired for a float position, position requires frequent travel to any health center as needed.