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Patient Service Representative

Company: SHARP HEALTHCARE
Location: Riverside
Posted on: November 26, 2022

Job Description:

Hours

Shift Start Time:

Variable Shift End Time:

Variable Additional Shift Information:

Weekend Requirements:

As Needed On-Call Required:

Yes

Sign On Bonus Payout Timeframe:

$250 - 90 days

$250 - 6 months

$500 - 1 year

Required Qualifications

  • H.S. Diploma or Equivalent
  • Less Than 1 Year Six months experience as a receptionist with a strong emphasis in customer service.Preferred Qualifications
    • Medical office experience.Other Qualification Requirements
      • AHA BLS for Healthcare Professionals required within the first 90 days. The department will track and maintain this certification.Essential Functions
        • Account review
          Processes customer issues promptly and prioritizes patient's needs.
          Investigates billing questions for patients and staff.
          Directs patients appropriately for additional assistance when issue can not be resolved.
          Reviews pertinent account information, notifies patients, and attempts collection of outstanding balances for all past visits.
          Utilizes leadership when circumstances (questionable financial standing, patient contests poor remarks) arise as needed.
        • Department operations
          Provides accurate information to all customers (including patients, providers, co-workers and visitors.)
          Monitors daily system reports (such as daily log, provider on-call schedule, department schedule, report, etc) as needed. Maintains the urgent care confidential file and collection codes.
          Maintains supply levels for work area, notifies supervisor of any repairs or maintenance needed in the environment and troubleshoots equipment problems if applicable. Orders supplies as needed.
          Knows procedure for activating appropriate emergency support systems (code blue, tire, disaster etc.) and monitors patient waiting area for potential emergency issues or safety concerns. Notifies security as needed.
          Alerts provider or nurse immediately of any potential medical emergencies. Utilizes the risk list as a guide. Initiates CPR as needed.
          Offers information and education to patients on customer services such as van shuttle, Nurse Connection and educational classes, and assists patients as needed with necessary forms and directions.
          Accurately balance batch for each shift worked - no more than 4 batch errors in a year (shortage/ overages, Reconciliation form incomplete, money not taped.)
          Confirms and/or updates all patient demographics, financial, insurance and primary care information.
          Collects co-payments and maintains co-payment collection rate per departmental guidelines. Collects co-payments for Lab and Occupational Medicine.
          Generates on-site itemized bill from MediLinks ED.
          Collects all charges from private pay patients according to SRS Policy and Procedures.
          Follows SRS Policy and Procedures for payment reversals, and UC Co-Payment Algorithm.
          Maintains safety of cash bags and keeps cash drawer locked. Ensures that their own deposits are rolled in safe after each shift worked and all keys are secure.
          Rounds on patients in lobby waiting more than 30 minutes and on family members or friends who are waiting on patients that are being treated. Maintains rounding log during each shift and is accountable to department standards for rounding.
          Assists with providing comfort measures (blankets, ice packs, water).
          Use of proper down-time procedures for GE/IDX, MediLinks ED and Enterprise (Touchworks).
          Ability to type a minimum of 30 words per minute.
          Prevents and monitors for disclosure of Protected Health Information (PHI) and reports incidents immediately to leadership.
          Review self pay patient's bill against nursing chart to verify accuracy at time of service.
        • Registration and eligibility
          Registers new patients accurately ensuring all required fields are completed. Registrations include ADHC notification and documentation of Notice of Patient Privacy laws and advanced directives.
          Provides standard welcome packet information to all new patients.
          Verifies and updates insurance and demographic information in IDX and MediLinks ED.
          Verifies insurance eligibility using internet-based eligibility verification resource or via the telephone. Documents proper financial comments to substantiate the eligibility or non-eligibility.
          Uses correct financial Status Classification (FSC) codes and logic. Understands how to read insurance cards and explain to patients at time of service.
          Documents pertinent facts and resolution in Financial Comments in CJ F/IDX for current and past visits.
          Obtains pre-authorizations for Urgent Care, Occupational Medicine and ancillary visits as needed.
          Contacts PMD offices for prior authorizations.
          Notifies nursing staff of patient's with possible ABNs prior to test completion.
          Notifies nursing and provider staff when patients are not eligible to be referred to SRS specialty departments such as Ortho or Cardiology.
        • Scheduling
          Utilizes PatientSecure to confirm patient identity prior to scheduling an appointment.
          Schedules appointments following appropriate provider guidelines for UC, Occupational Medicine and ancillary services.
          Schedules same day patient appointments in GE/IOX and MediLinks ED and other pertinent applications.
          Responsible for other scheduling (TouchWorks, Orders, exam preparations) as identified by site.
          Arrives patients in the GE/IDX system accurately and within established timeframes as needed.
          Notifies provider when senior patients are eligible for HCC coding. Flags chart per department guidelines.
          Registers Lab patients for appointments after hours and on weekends.
        • Teamwork and development
          Displays the willingness to float and assist in other departments and at other sites.
          Prioritizes assignments effectively by setting individual work goals and objectives in consultation with co-workers and leadership.
          Troubleshoots potential and actual problems while keeping leadership informed in a timely manner when problematic situations arise.
          Maintains current knowledge of all pertinent in-services GE/IDX applications, MediLinksED system, Enterprise (Touchworks, scheduling guidelines, safety and health-related in-services, etc) by documented attendance at programs, training, or in-services.
          Demonstrates practical knowledge of current phone system and other related equipment.
          Identifies personal and individual needs for skills development and pursues training opportunities.
          Brings ideas to leadership for programs or procedures that will help the department to better serve its patients, providers, co-workers, and visitors.
          Provides, and is receptive to, feedback about care and service delivery in a positive and constructive manner.
          Performs all other duties as required by Director, Patient Care Manager, coordinator, lead, or supervisor.
        • Telephone and message management
          Takes complete messages that are formatted neatly and concisely, spelled correctly, and written using correct medical terminology.
          Returns phone messages according to established guidelines and documents appropriately.
          Responsible for other possible measures for above items as applicable.
          Refrains from personal calls at the front desk; refrains from chewing gum.
          Types proficiently and accurately; has the ability to proof work.
          Consistently abides by and demonstrates the Sharp Healthcare Telephone Standards.
          Manages multiple telephone lines simultaneously while providing superior customer service and attempting to maintain first call resolution.
        • Training
          Maintains current knowledge of insurance contracts.
          Assists with the training of new hires for insurance and financial matters.
          Attends Business Service Representative training during orientation and functions in that role as needed.
          Knowledge, Skills, and Abilities
          • Medical Terminology is preferred.
          • Proficiency in the use of computers and the internet for business related activities.
          • Capable of efficiently managing multiple phone lines in a professional office setting. Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability or any other protected class

            H.S. Diploma or Equivalent

Keywords: SHARP HEALTHCARE, Riverside , Patient Service Representative , Human Resources , Riverside, California

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