PSR

Overview

Primary Accountability

 

Provides administrative support to ensure patients are welcomed to the organization, scheduled and registered for services in various departments within the organization. Responsible for supporting Medical, Dental, Eye Care, Call Center, or Patient Benefit teams in the efficient processing of patients and the successful application of fiscal procedures.

Responsibilities

Description of Primary Responsibilities

Patient Services Representative (Medical/Dental/Eye Care/Call Center/Patient Benefits):

Responsible for scheduling appointments, welcoming patients, registering and supporting patients until patient is seen for their scheduled services.

Responsible to pre-register patients which includes verification of insurance coverage, creating and assigning cases as needed, and confirmation that appointment meets scheduling protocols.

Responsible to ensure completion of all necessary medical, dental, optical and Patient Benefit forms utilizing electronic or paper.

Responsible to collect patient co-payment/co-insurance at time of service or initiate payment plan according to company protocol.

Responsible to ensure patient emergencies are immediately communicated to clinical staff.

Responsible to drive quality initiatives to improve preventative care across the organization.

Responsible to assist patients in selecting a Managed Care Plan and/or Primary Care Provider.

Responsible to assist patients with completing Labor and Industries forms.

Responsible for the proper handling of company property per protocols and manufacturer and health and safety recommendations.

Responsible to complete no-show call-backs on a daily basis to promote the company’s policies and educate on alternative support services.

Responsible to handle basic medical records requests.

Responsible to ensure patient waiting areas are presentable and managed according to company standards.

Responsible to promote a positive work culture and upholds clinic policies and procedures, including the WE CARE standards of Behavior.

Responsible to uphold confidentiality at all times in regards to CBHA activities, reports, financials, patient health information and other proprietary information specific to CBHA.

Other duties as assigned

Specific area responsibilities as assigned:

Dental

Responsible for dental prior-authorizations.

Responsible to completes prior-authorizations for dental procedures and submits x-rays.

Responsible for transferring medical records to other providers or to ensure referrals are completed.

Responsible to provide follow-up with patients after response from insurance company.

Responsible to sets up patients with orthodontic payment booklets and ensures timely payments are made prior to scheduling next month’s services.

Responsible to ensure orthodontic charts are available and up-to-date at time of service

Responsible for the coordination of pediatric dental surgery schedules, pre-op medical clearances and other needed documentation to ensure pre-procedure compliance to company protocols, as assigned.

Travel to multiple school and community locations as assigned, sometimes requiring early start times or schedule flexibility.

Interact professionally and compassionately with children of various ages during dental screening activities.

Communicate effectively with school nurses, teachers, and administrative staff to coordinate screening schedules and logistics.

Prepare, organize, and transport screening materials and supplies to school and community sites.

Ensure proper consent, documentation, and confidentiality requirements are followed.

Call Center:

Responsible to identify and transfer incoming calls for all CBHA sites to the appropriate department including sending necessary communication to provider teams via phone notes through the medical records system.

Description of Primary Attributes

 

General Development:

Ability to work with confidential information.

Ability to multi-task with high degree of accuracy and organization.

Demonstrates great customer service skills and ability to communicate professionally with patients, specialty clinics, and vendors.

Possesses skills in motivation, self-direction and punctuality.

Ability to work well as part of a team and keep team members updated on current project developments.

Models excellent customer service:

Provides exemplary customer service

Promotes utilization and standardization of AIDET model

Supports managers with patient relations and clinic experience

Qualifications

Professional and Technical Knowledge:

Possesses basic level to advanced level experience of written and verbal communication skills, computational and computer skills, and mathematical knowledge typically acquired through completion of a high school program.

Two (2) years of customer service experience.

Technical Skills:

Requires strong verbal communication, customer service, interpersonal skills and telephone etiquette.

Cooperatively interacts with the health care team to support and contribute to the shared group goals.

Ability to work under minimal supervision and with a variety of departments for scheduling purposes

Continuously promote and lead improvement efforts within the department

Requires critical thinking skills, analytical skills, and able to take appropriate action in a stressful environment.

Able to react effectively and calmly in emergencies.

Ability to train staff members using variety of training tools

Ability to prepare basic correspondence and simple reports in Microsoft Word.

Ability to use Microsoft Excel to create tables and simple displays of information.

Possesses working knowledge of standard office equipment.

Communication Skills:

Ability to speak, read, write, and translate both English and Spanish.

Communicates complex concepts in a clear, effective manner for a general audience.

Possesses excellent cross-cultural communication skills/culture competency.

Exercises tact and diplomacy in the resolution of mild conflicts or disagreements.

Effectively communicates information in written (including electronic) correspondence.

Effectively communicates information during informal and formal verbal presentations.

Blood/Fluid Exposure Risk:

According to this position this is a Category II.

Category I: Tasks routinely involve a potential for mucous membrane or skin contact exposure to blood, fluids or tissue. Use of personal protective equipment (PPE), when appropriate, is required.

Category II: Usual Tasks do not involve exposure to blood, body fluid, or tissues but may require performing Unplanned Category I tasks.

Category III: Tasks involve no greater exposure to blood, body fluids or tissues than would be encountered by a visit. Category I tasks are not a condition of employment.

Physical Demands:

Ability to stand, walk, sit, use hands, fingers, and talk frequently

Ability to lift up to 25 pounds

Close vision (clear vision at 20 inches or less)

Distance vision (clear vision at 20 feet or more)

Ability to adjust focus (ability to adjust the eye to bring an object into sharp focus)

Travel:

Travel to various clinic sites is required.

Must possess a valid driver’s license and be insurable under the company’s liability coverage to drive company vehicle.