Representative, Patient Service Rep Ii

Summary:
This position provides clinical and clerical support for patients within the inpatient and outpatient medical clinics/practices and is the initial focal point of the patient experience. Responsible for the gathering, entry and verification of registration information. In addition, this position is responsible for the collection of co-pays, may provide entry of patient charges and facilitates the care process by effectively processing information in a timely and accurate manner. This position must retain a high level of professionalism at all points of time.
Education Requirement:
Successful completion of an approved Medical Assistant program. Qualified by education, training or experience to work with the school-age, adolescent, adult and/or geriatric patient as specialty assignment dictates.
Experience Requirement:
One (1) experience as a medical assistant.
Licensure/Certification Requirement:
Documentation of a national certification as a Certified Medical Assistant through the American Association of Medical Assistants (AAMA) or for the Registered Medical Assistant (RMA) through the American Medical Technologists (AMT) required within nine (9) months of hire. CPR Certification.
Key Job Responsibilities:

1. Greets patients upon arrival in practice.
2. Completes and verifies registration information for each patient:
   1. Verifies patient identity per protocol.
   2. Verifies address utilizing open ended questions.
   3. Ensures benefit verification process for current service date has been completed.
   4. Scans insurance card(s) into system.
   5. Ensures patient has received HIPAA, Financial Policy, MSP, Pt Notification of Provider based clinic (if appropriate) have been signed, and scans as needed into system.
3. Collect co-pay as well as any outstanding self-pay balance:
   1. Provide patient with receipt of transaction.
   2. Enter into system.
   3. Maintain cash-drawer, reconcile any end-of-day cash receipts per ambulatory protocol.
4. Updates system as "checked in" for communication with clinical staff.
5. Performs various clinical tasks such as taking patient's vital signs, specimen collection, EKG and blood collection as required.
6. Works assigned encounter edits on a frequent basis throughout the day. Depending upon size of department assigned work could be also be Encounter Prep, Eligibility Checks, Appointments to schedule, Appointments to re-schedule, no-shows, encounters with no charge.
7. Performs check-out duties for patients as they exit practice: a) Schedules patient for follow-up as requested by provider and B) Provides assistance for referrals as directed.
8. Consistently monitors waiting room for potential customer service issues. Updates patients on a ten (10) minute frequency when providers are running behind in schedule.
9. Understands and performs individual role in assuring compliance for regulatory, accreditation and system process.
10. If assigned, answers phone and routes patient to appropriate clinical or administration area.
11. If dedicated scheduling staff do not exist in the department, schedules both new patients and follow-up care based on patients calling into the practice. If scheduling new patients, responsible for obtaining necessary information for insurance verification.
12. Maintains communication with Practice Manager on daily basis.
13. Assists patients in obtaining necessary referrals for follow-up services. Also could be responsible for obtaining proper authorizations and pre-certifications for all outside procedures scheduled through the outpatient clinic or department.
14. Collaborates with forensic team and law enforcement officials as it relates to the care of inmates and arrestees in order to maintain a safe and secure environment at all times.
15. Maintains confidentiality of patient, department and hospital information. Adheres to established department and organization policies in processing and releasing patient information (i.e. HIPPA, Confidentiality and Compliance Policies).
16. Back-up and provides coverage for relief and absences as required. Demonstrates flexibility of work schedule/duty assignments.
17. Performs other duties and responsibilities as required.

Knowledge/Skills/Abilities:

• Excellent communication skills as well as knowledge of ambulatory/outpatient department operations.
• Strong interpersonal skills necessary to function as liaison between physicians, office staff and the patients and their family members and be able to demonstrate a high level of customer service when working with patients who present under adverse situations.
• Knowledge of clinic/ambulatory department protocol, understanding of coding, procedures, and equipment.
• Knowledge of both governmental and private insurance rules for payment, including how to read an insurance card.
• Self-motivated and possess a high level of judgment skills and initiative, along with ability to prioritize and coordinate several tasks simultaneously, while retaining a confident, knowledgeable and helpful demeanor.
• Demonstrates knowledge and skills to provide care, maintain clinical competency and meet patient population needs within clinic.
• Ability to maintain a positive attitude towards health care team members and diverse patient populations required.

Supervision Provided by this Job:

• No supervisory responsibilities.

Physical Demands/Conditions:

• Prolonged standing and walking; lifting, turning patients and equipment; repeated bending, squatting and stooping; exposure to infectious agents. Visual acuity is needed to assess color changes, to verify accuracy of written materials, and to administer and accurately prepare medications. Heavy Work - Exerting up to 150 pounds of force occasionally, and/or up to 75 pounds of force frequently, and/or up to 30 pounds of force constantly to move objects. (May be further defined as "with or without assistance.")