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Patient Support Services Representative
3 months ago
Responsible to train in all Patient Support Services roles, which includes Scheduling, Referrals, Diagnostics, Medical Records, Patient Care Coordinator, and Lab Tracking. This position will fill in the department, as needed on a daily basis.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
JOB SPECIFIC DUTIES:
- Answer telephone calls courteously using proper greeting and name
- Manage telephone traffic into the support center by answering incoming calls within two rings
- Schedule patient appointments, monitoring the schedule to ensure appropriate appointment placement, allotting sufficient time for special procedures or lengthy exams
- Screen incoming calls and transfer calls to other staff as necessary
- Place outbound follow-up calls or transfer calls to front offices and/or Patient Care Coordinators
- Task Nurse/Medical Assistant or Patient Care Coordinator with patient information or questions
- Answer questions about appointments, Sliding Fee Scale, or other issues as needed.
- Reschedule appointments.
- Update patient’s demographic information in NextGen
- Communicate and interact effectively with patients and families, physicians, and peers to maximize successful patient outcomes.
- Collect payment information for payment on accounts.
- Ensure that all faxes and materials pertinent to patient charts are scanned and/or filed in an accurate and timely manner for all locations
- Ensure that patient documents and health records are filed and maintained.
- Complete order tracking, order management and protocol from received mail and faxes.
- Sort and deliver incoming postal mail.
- Process release of medical record requests.
- Coordinate all aspects of a specialty and/or diagnostic referral in a timely manner when requested by Grace Health providers.
- Check the diagnosis code on specialty and/or diagnostic orders to make sure they meet insurance guidelines and are medically necessary.
- Call and schedule patient’s test and inform the patient on when and where to go.
- Verify insurance coverage and obtain prior authorizations for services to be rendered as required by individual insurance plans.
- Ensure that the specialist accepts the patient’s insurance plan.
- Assemble paperwork and requested medical information and submit to the specialty office as needed.
- Communicate referral information to the patient and providers.
- Document appointment or preauthorization information in Nextgen EMR or in an electronic log of all referrals.
- Verify that the office has received the diagnostic or specialty report when ordered.
- Conduct patient outreach when the patient has not been compliant with a provider’s order; one phone call and one sent letter.
- Document patient’s non-compliance in Next Gen Order Management section and Manage Selected Referral or on the electronic log.
- Respond to patient concerns timely and ensure patient satisfaction.
- Inform patients of normal/abnormal labs, diagnostics
- Collaborates with pharmacies and provider(s) to ensure accuracy and safety of medication
- Knowledgeable on Community Resources
- Facilitates care with transportation services, home health agencies, physician offices, equipment companies, and nursing homes.
- Maintain current license and certification, if applicable.
- Documents all patient communication(s) in EMR, appropriately.
- Complete PHI log per policy
- Professionally investigates and resolves patient barriers to completing lab results.
- Creates a welcoming and professional environment for our patients and visitors by demonstrating exceptional customer service.
- Follows standards and guidelines for telephone etiquette and service when interacting with patients over the phone.
- Consult with and support clinical staff in the efforts to serve patients and clinics.
- Routinely generate a lab tracking report or work electronic log of ordered labs.
- Conduct patient outreach when the patient has not been compliant with a provider’s order.
- Document patient’s non-compliance in lab orders section.
- Perform other duties as assigned
GENERAL DUTIES: - Follows policies and procedures of the office, including administrative, clinical, quality assurance, and personnel
- Maintain good attendance (daily, meetings, and other assignment tasks)
- Maintain timely documentation of all work assignments
- Maintain patient confidentiality
- Routinely keep supervisor informed about attendance and job assignments
- Flexible in being able to multitask
- Work effectively and at an efficient pace
- Work cooperatively with physicians, administration, and peers
- Grace Health recognizes that managing patient care is a team effort that involves clinical and non-clinical staff. All employees must embrace a team-based approach to patient care and understand that each role is important to our success.
- Team members must demonstrate excellent team communication and coordination to provide quality patient care.
- Care coordination includes communicating with community organizations, health plans, facilities, and specialists.
- Care team members understand and embrace the concept of population management and proactively address the needs of patients and families served by this practice.
- Team members must demonstrate skill and knowledge related to effective communication with vulnerable patient populations.
- Team members must participate in Continuous Quality Improvement activities within the organization to ensure patients receive high quality care.
- All team members will be involved in the process of improving quality incomes.
- Team members will participate in the review and evaluation processes of practice performance and help to identify opportunities for improvement.
- Team members will participate in Grace Health's advocacy program.
- Follows policies and procedures of the office, including administrative, clinical, quality assurance, and personnel
- Maintains good attendance (daily, meetings, and other assignment tasks)
- Maintains timely documentation of all work assignments
- Maintains patient confidentiality
- Routinely keeps supervisor informed about attendance and job assignments
- Flexible in being able to multitask
- Works effectively and at an efficient pace
- Works cooperatively with providers, administration, and peers
To perform this job successfully, an individual must be able to assist in advancing Grace Health’s mission and to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
SKILLS:
- Pleasant personality and professional demeanor
- Cooperative attitude-Flexible
- Detail Oriented
- Able to work with minimal supervision
- Highly organized work habits with ability to prioritize
- Intermediate computer skills with Microsoft Word and Excel
- Familiar with Electronic Medical Records
Must have completed high school or equivalent. Prefer 1 year Medical Office experience. Prefer RMA or CMA.
Grace Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
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