Patient Assistance Representative

MIDLAND COMMUNITY HEALTHCARE SERVICES, INC.

Midland, Texas

JOB DESCRIPTION

JOB TITLE:                                       PATIENT ASSISTANCE REPRESENTATIVE

DEPARTMENT:                                PATIENT ASSISTANCE OFFICE

REPORTS TO:                                   PATIENT ASSISTANCE MANAGER

OES CODE:                                        43-4061

FLSA EXEMPTIONS STATUS:        NON-EXEMPT

JOB SUMMARY

Patient Assistance Representatives play an important supporting role to the staff and patients of Midland Community Healthcare Services.  They are expected to provide excellent customer service while leading the patient through the benefit determination process and financial/community assistance processes. They maintain the information of the patients in a manner consistent with administrative, ethical, legal, and regulatory requirements. They also process, maintain, compile, and report information for the finance department and quality improvement programs.

JOB DUTIES

• Answer applicant’s questions about benefits and benefit process.
• Interview benefits recipients at specified intervals to certify their eligibility for continued benefits.
• Interpret and explain information such as eligibility requirements, application details, payment methods, and applicant’s rights and responsibilities.
• Integrate procedures to grant, modify, deny, or terminate assistance, or refer applicants to other agencies for assistance.
• Compile, record, and evaluate personal and financial data in order to verify completeness and accuracy, and determine eligibility status.
• Verify employers and/or other references to verify answers and obtain further information regarding eligibility.
• Screen and assist in the preparation of applicant forms for internal and external program benefits such as Medicare, Medicaid, CHIP, CHIP: Perinatal, Women’s Health Program, Title V, PHC, and FQHC.
• Review records for completeness, accuracy, and compliance with regulations.
• Assist patients by making the appropriate medical, dental, or mental health appointments needed.
• Assist pregnant patients by forwarding their information to registration at the hospital for delivery.
• Follow-up on program approval and denial.
• Ensure the completeness of the patient record including patient demographics.
• Prepare and complete end of month reports as well as all other financial and quality assurance data.
• Participate in cross-training opportunities in order to help the organization operate as a whole.
• Send client correspondence as required through clinic procedure.
• Performs other duties as assigned by the Patient Assistance Manager.

SUPERVISORY RESPONSIBILITIES

• No Supervisory Responsibilities are included in this position.

CRITICAL SKILLS AND ABILITIES

• Customer Service Oriented.
• Oral Comprehension, Expression, Recognition, and Clarity.
• Written Comprehension and Expression.
• Computer & Technology Skills - The ability to navigate and utilize Microsoft Office, and the ability to learn to navigate and utilize proprietary medical software packages.
• Time Management – The ability to prioritize tasks in order to best serve the patient and the flow of the clinic.
• Cultural Competency – the ability to deal with people of various cultures and social status, as well as outside entities

QUALIFICATION REQUIREMENTS

• Must have a High School Diploma or G.E.D.
• 1-3 years of customer service experience preferred.
• 1-3 years of eligibility interviewing experience preferred.
• No felony results on a criminal background screening.
• Drug Screen Test with a negative result.

WORK ENVIRONMENT/CONDITIONS

BBP Class III:  This position does not include any exposure-prone duties. These employees will still receive basic personal protective equipment training, basic bloodborne pathogen standard training, and safety precautions. Employees in this class are still to be offered vaccinations provided by Midland Community Healthcare Services if wanted.

Physical Demand:  Ability to interact with patients and operate office equipment for patient services.  Employees will need the ability to lift a minimum of 25 lbs, or more, independently as necessary.  Vision abilities are required to read and verify patient information, to read information on medical records, and the read information on computer systems.  Ability to pull, push, lift, and manipulate equipment and files. The ability to move freely about the front office and medical record areas in order to perform the job duties is required.  In compliance with EEOC 29 CFR part 1630, reasonable accommodations will be made for those employees with disabilities in order to assist them in performing the job duties and demands, provided it does not constitute undue hardship upon MCHS.

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Employee                                                                                              Date