Patient Services Rep Full Time

2 months ago

Rochester, United States Wentworth-Douglas Hospital Full time

Wentworth-Douglass Hospital, an affiliate of Mass General Brigham, is committed to supporting patient care, research, teaching, and service to the community. We place great value on being a diverse, equitable and inclusive organization as we aim to reflect the diversity of the patients we serve. At Mass General Brigham, we believe in equal access to quality care, employment and advancement opportunities encompassing the full spectrum of human diversity: race, gender, sexual orientation, ability, religion, ethnicity, national origin and all the other forms of human presence and expression that make us better able to provide innovative and cutting-edge healthcare and research.

1. Performs check-in duties in the practice.
- Receives and welcomes all patients into the practice in a manner that is consistent with WHP service expectations, and the Language of Caring program as outlined in support of patient satisfaction. Appropriately refers patient to the proper party within the office. Verifies patient using two patient identifiers.
- Verifies all patient demographic and insurance-related insurance at each visit and ensures that all data is entered in the system in an accurate and timely manner per any established protocol.
- Ensures all required disclosure and registration forms are current and maintained in the patient's record as required per any established policies and procedures.
- Collect patient co-pays and self-pay balances. Accurately posts payments to patient accounts.
- Performs insurance verification per any established WHP policies and procedures. Completes electronic practice management (PM) tasks associated with insurance verification. Generates and has patient sign an ABN as appropriate.
- Enrolls patients to the Patient Portal and responds to Patient Portal inquiries per any established policies and procedures.
- Coordinates requests for interpreter services, documents and completes declination, if applicable.
- Completes end-of-day reconciliation per protocol; includes preparation of the daily deposit, reconciliation of daily credit card transactions; batch reconciliation; reconciles the procedure log report and kept appointment reporting/reconciliation. Uploads all reports and deposit information to shared drive.
2. Performs check-out duties in the practice.
- Receives and welcomes all patients to check-out in a manner that is consistent with WHP service expectations and the Language of Caring. Verifies patient using two patient identifiers.
- Schedules all follow up appointments as indicated by the provider including checking for future appointments to ensure no duplicates.
- Generates patient plan at check-out completion. Uploads automatically to Patient Portal - and/or prints and provides to patient.
- Updates ACO First Visit Notification Date.
3. Performs referral /diagnostic / lab orders processing duties in the practice.
- Processes all referrals / diagnostic / lab orders, including electronically in those practices utilizing an EHR, and ensures that specialist offices receive relevant notes, labs and other testing results as applicable. All forms that are required by a specialist's office will also be completed and sent. Documentation should be transmitted electronically whenever possible.
- Facilitates the scheduling of appointments for other physician offices as well as outpatient procedures.
- Ensures compliance with all necessary insurance carriers' pre-certification requirements by processing pre-certifications as required.
- Ensures appropriate forms are submitted to centralized scheduling for outpatient procedures.
- Instructs patient of proper preparation for procedures.
- Runs medical necessity checks on all labs and diagnostics, per protocol, and has the patient sign an ABN as needed.
4. Performs administrative duties in the practice.
- Collaborates with clinical staff and notifies patient of any appointment delays.
- Answers the telephone per customer service standards. Reviews outstanding diagnostic and referral orders.
- Responds to emergencies and summons the appropriate personnel.
- Greets and acknowledges visitors upon arrival consistent with service standards and the Language of Caring and assists as appropriate.
- Files, faxes, collate, and photocopy material as required (including all electronic documentation).
- Performs chart prep process - per any established protocols.
5. Medical records filing and related tasks.
- Maintains file system according to WHP and department standards. Collaborates with clinical staff to perform data entry tasks related to pre-load of new patient records, non-interfaced diagnostics and orders management of incoming consultation reports/notes. Scans medical record information received via paper to the patient EHR - per any established protocols.
- In compliance with all applicable policies and procedures, copies and sends all medical records as requested or ensures that requests for medical record information is forwarded to the medica

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