Patient Care Representative

3 weeks ago

Oak Park, United States Pcc Community Wellness Center Full time

**Department**:Clinic Administration

**Manager Title**:Office Manager

**FLSA Status**:Non-Exempt

**Job Summary**: _Responsible for the operations of the reception area, registering and scheduling of patients, collecting co-pays and money charged for services rendered and handling all patient inquiries._

**Essential Duties and Responsibilities**:

- Greets all patients, staff, visitors, and vendors in a professional and welcoming manner
- Schedules appointments in order to track billing slips to ensure charge capture occurs
- Prepares for day, reviews _Eligibility and Phone_ report, prepares any new patient charts and/or paperwork at patient presentation
- Performs registration in clinic setting and via telephone to ensure demographic and insurance information is accurate and complete
- Obtains copies of insurance cards, drivers license, authorizations, and referrals and scan or enter them into electronic health record
- Ensures all requirements and fields noted on the Check-In and Check-Out page are satisfied and complete
- Collects co-payments and outstanding balances at Check-In, and time of service balances and estimated balances at Check-Out according to policy
- Reviews and complies with Patient Account Notes and Appointment Notes in electronic health record
- Refers patients to Financial Counselors regarding past due balances, questions and/or resolution that PCRs are unable to answer
- Processes claim creations in electronic health record at Check-Out
- Submits appropriate claims for Real Time Adjudication
- Works _Day End Review_ report and designated Tier-based HOLD Claim Worklist(s) on a daily basis
- Accepts accountability for all Worklists on the dashboard or elsewhere based on assignment
- Answers the telephone directing calls to appropriate areas or takes messages and relays them to the appropriate staff member as necessary
- Informs patient of privacy policies and procedures
- Informs patients of delays in physician schedules, assists with patient comfort while delayed
- Schedules follow-up appointments, creates appointment ticklers in electronic health record, and works associated Worklists relative to both based on assignment
- Creates a Time of Service batch and links it to a deposit batch daily
- Reconciles, balances, and closes each batch /drawer at end of day
- Turns over batches to the designated resource daily
- Covers for other staff in reception, including other office locations
- Processes all releases for medical information ensuring appropriate consents are completed, adhering to PCCs HIPAA and privacy guidelines
- Drive continual quality improvement through participation in organizational quality improvement efforts that may include but are not limited to patient satisfaction, clinical and operational quality improvement initiatives.
- Maintains a neat and orderly work area
- Performs other duties as assigned

**Experience/Training**:

- High school diploma or equivalent
- 1 - 2 years EMR experience in medical setting preferred
- Constantly communicates with patients, families, and other healthcare providers. Must be able to exchange accurate information in these situations.
- Proficient in MS Office Business Applications to include: Outlook, Word, PowerPoint, and Excel.

**Certifications/Licenses**:

- None

**Physical Demands**:

- Must be able to remain in a stationary position 50% of the time.
- Must be able to move around the clinic site 50% of the time.
- Constantly operates a computer, computer printer, copy machine, and telephone.
- Occasionally positions self to maintain exertion of physical strength to move objects of 10 pounds from one level to another.
- Must be able to transport from one site to another.
- Must be able to cover other shifts as necessary.

**Other Skills**
- Ability to read and write proficiently using the English language.
- Constantly communicates with other healthcare providers. Must be able to exchange accurate information in these situations.
- Follow-through, assume responsibility and use good judgment.
- Maintain professionalism under stressful situations.
- Self-motivated and directed with the ability to prioritize and work efficiently under pressure.
- Ability to understand and follow verbal and written communication.
- Detail oriented with the ability to work with mínimal/no supervision.
- Willingness to be part of a team-unit and cooperate in the accomplishment of departmental goals and objectives.
- Effective and creative problem solving.

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