Patient Services Representative

Summary:

Our Patient Services Representative is the first impression for all patients, families, and visitors that enter the building. Works cooperatively with all hospital and clinic staff, medical staff, patients, and visitors.

Essential Functions:

1. Demonstrates behaviors consistent with organizational mission & goals.

2. Demonstrates practices to keep all medical information confidential by complying to HIPAA Policies & Procedures.

3. Demonstrates behaviors that promote positive patient/staff relations.

4. Comes to work as scheduled; arrives for work on time and is ready to perform duties when shift begins.

5. Demonstrates proper safety practices in carrying out job duties.

6. Appearance is appropriate to job duties, wears identification on duty.

7. Demonstrates appropriate job competencies.

8. Complies with organizational policies in course of duties.

9. Competence using equipment such as copy machines, fax machines, scanners, computer programs such as Word, Excel, and our electronic health record.

10. Review and complete tasks in SQSS as assigned.

11. Schedules new & return appointments; explains registration process and provides directions to patients.

12. Answers telephone in professional, courteous manner while smiling, and directs phone calls or messages to the appropriate personnel or department.

13. Prioritizes work and provides prompt, efficient service to staff, patients and visitors while remaining flexible.

14. Facilitate patient flow through the clinic and hospital being aware of delays and communicating with patients and staff.

15. Demonstrate a high level of mental/emotional tolerance and even temperament in dealing with ill people; use tact, sensitivity, sound judgement, and professional attitude when relating with patients, families, and coworkers.

16. Meets policies and procedures, QA, Safety, Emergency Procedures, and Infection Control standards of the area.

17. Able to delegate time within multiple units of the facility as needed.

18. Performs all elements of the patient intake process with proven accuracy:

a. Master Patient Index inquiries performed using established identifiers. Patient types are correctly assigned.

b. Demographic information is collected/updated in the electronic medical record, including but not limited to emergency contact, telephone numbers, social security number, next of kin, race/ethnicity, and guarantor.

c. Benefits are identified, verified, coordinated, and entered in the electronic medical record.

19. Medicare requirements are fulfilled:

a. Medicare Secondary Payer (MSP) Questionnaire is completed with the patient, stored with the account, and benefits are coordinated correctly.

b. Retirement dates are obtained, and information updated in the retirement spreadsheet.

20. Determines and informs patient/guarantor of financial responsibility and collects at point of service, issuing receipts as appropriate.

21. Appropriately documents notes and reviews notes on each account.

22. Consistently provides explanations and information to the patient and obtains signatures as appropriate on the Consent to Treat and Release of Information form.

23. Patient ID, insurance cards, eligibility responses, signed consent, and all other documents are scanned clearly and consistently to the patient’s account.

24. Ability to perform insurance verification, medical necessity checks, and prior authorizations through EMR, websites, or telephone calls with insurance companies.

25. Know the process for Veterans Choice, Optum VA, or similar referrals for clinic and hospital.

26. Know the process for prior authorizations to be completed for all departments in the facility.

27. Obtain any ABNs or Patient Liability Waivers as required by insurance companies.

28. Consults other departments as needed to facilitate interdisciplinary approach to patient visits.

29. Responsible for understanding clinic & hospital policies and communicating such to patients and families.

30. Fosters positive public relations for the organization, internally and externally with all customers.

31. Establishes a customer friendly environment that treats patients and families with respect and dignity and reflects positively on RCHC’s mission, vision, and values. Strive for excellence, go above and beyond for our patients.

32. Maintains a good working relationship with clinic staff, medical providers, and hospital service areas.

33. Keep reception area clean and well stocked with necessary supplies.

34. Assist with orientation of new staff.

35. Assist other staff with work assignments.

36. Seek involvement in department activities and committees.

37. Participation in in-service training as well as other opportunities for professional development as assigned by RCHC management.

38. Performs all other duties as may be assigned by management staff.

Patient Services Representative pg. 3

39. Willingness to cross-train with RCHC/Rawlins-Clinic patient services and billing staff as needed.

Competencies:

1. Able to work independently and focus on the task at hand in a busy environment.

2. Positive attitude and people skills are a necessity.

3. Must be detail oriented and perform a thorough job in all responsibilities.

4. Must have excellent telephone etiquette.

5. Proficient with filing and maintaining patient charts.

6. Strong Word and Excel spreadsheet skills.

7. Able to operate photocopier and fax machine.

8. Strong customer service skills.

Position Qualifications:

Minimum Education: Minimum of a high school education or GED.

Minimum Experience: One or more years of previous experience preferred. Basic computer knowledge required.

Certifications/Licensures: N/A

Working Environment: Mostly sedentary work within clinic office setting with some minor lifting and/or carrying involved in normal course of work duties. Clinic reception personnel are asked to assist in keeping work areas clean and uncluttered at all times to provide a positive image for incoming patients and family members.

Physical Demands: **

Stand: Frequently

Walk: Frequently

Sit: Frequently

Squat/Kneel: Occasionally

Bend: Occasionally

Lift/Carry:

0-10 pounds: Occasionally

10-20 pounds: Occasionally

20-50 pounds: Occasionally

50-100 pounds: Never

100+ pounds: Never

Push/Pull:

10-25 pounds: Occasionally

25-50 pounds: Occasionally

50-100 pounds: Never

100+ pounds: Never

**Reasonable accommodations may be made to enable individuals with disabilities to perform the position accountabilities without compromising patient care or departmental efficiency. However, should it de determined that the employee cannot meet the position accountabilities with or without accommodation, it is the right of RCHC to release the individual under Kansas “Employment at Will” doctrine**

Professional Requirements: Adheres to policies, procedures, and always maintains confidentiality. Attends annual in-services completes annual education in a timely manner. Represents RCHC in a positive, professional manner on the job, electronically and in the community. Complies with all hospital policies regarding ethical business practices; communicates the mission statement & core values of RCHC both on and off the job.