Patient Service Rep III

Northern Light Eastern Maine Medical CenterDepartment: Orthopedic Trauma ClinicPosition is located: Northern Light Eastern Maine Medical CenterWork Type: Full TimeHours Per Week: 40.00Work Schedule: 7:30 AM to 5:00 PMPosition may be eligible for a $1000 bonus (minus tax) paid after the successful completion of probation period. (external only) Summary:The Patient Service Representative III is a supporting position and is responsible for a variety of activities related to patient in-take and care. The Patient Service Representative III will also support the Patient Service Representatives I and II as required and may be the first point of contact for patients entering the practice. It involves all of the responsibilities of the PSR II but with a higher level of competency and experience. Activities may include but are not limited to greeting and checking in patients, verifying and updating insurance information and confirming other patient information, scheduling patient appointments, answering phones, updating demographic information, processing referrals, payment collection and posting, charge entry, chart preparation, processing of payroll, tracking of time and attendance, tracking of quality metrics, daily charges, schedule management, patient panels, taking meeting notes, assist with patient complaints ordering office supplies, assisting with practice orientation and training of new staff and other duties as assigned with a minimum of support. The PSR III will also be able to coordinate all components of patient appointments to include tests, surgeries and procedures and may work closely with Central Scheduling. The PSR III will be expected to work with a fair amount of independence applying logic and judgement towards the resolution of practice challenges. The PSR III will serve as a role model of service and professionalism to all supporting staff. This role will provide help with mentoring new staff.Responsibilities:Communicates EffectivelyDemonstrates effective and courteous Customer, Physician/Practice Staff and other hospital staff communication skillsCommunicates in a way that conveys understanding and respect to a diverse patient and work populationAnswers all calls promptly and courteouslyResponds to and resolves issues promptly through effective communicationUses appropriate chain of commandFeedback is provided in a constructive mannerDemonstrates problem solving skills by responding to and resolving issues promptly through effective communication skillsMaintains adaptability in work schedule to meet patient/departmental needsDevelops and maintains positive working relationshipsActs as a resource to coworkersConfirms patient identity by using the full nameParticipates in problem solving groups as requestedGives instructions and directions in a clear, understandable mannerHandles patient/family situations that have been escalated to the PSR II in a calm, courteous and informed professional demeanorAttends all practice staff meetingsGreeting patients, having patient(s) sign appropriate forms/consentsVerifying and updating demographic/insurance information on all encounter forms and systems per protocol. Notifying registration of changes if applicableDemonstrating mastery of appropriate practice software and registration tool protocolsScheduling tests, procedures, referral appointments with scheduling center, agencies and/or other provider groups and forwarding order form and/or records to appropriate depart/office. Documenting information in Patient's chart. Processing insurance referral/prior authorization and document this per protocolRetrieving and processing messages per protocolMay assist with orientating and training/cross-training of new and established employees as assignedHas the knowledge and the ability to train support staff at all practice levels and for all practice functions, if appropriateMay provide coverage in other areasEffectively covers other support positions (e.g. switchboard, insurance referrals, and scheduler), if appropriateProvides excellent customer service for both internal and external customersResponds to communications (phone calls, voice mails, e-mails and IMs) in a timely mannerDemonstrates mastery of and acts as a resource for all systems used in the front office, including scheduling and registration protocols, if appropriateTakes ownership for determining customers' needs and offering assistanceInteracts with other Northern Light Health functions with confidence, courtesy and professionalismAssists the practice manager in organizing, coordinating and implementing projects.Collects and compiles statistical data to assist the practice manager as requiredSchedules outpatient testing per orders/referral process, inputs appointment dates and times into patient EMR, if appropriateRecognizes problems and offers constructive solutions. Is able to implement solutions with direction from the practice managerIs able to run staff meetings in the practice manager's absenceActs as a designee for the safety officer for practice, to include all safety training, conducting safety related drills, documenting all safety procedures. The PSR III will also participate in disaster drills, demonstrate understanding of disaster plan in discussion drills and disaster situations. The PSR III will also perform duties as assigned to meet unusual, emergent and practice needs100% documented evidence of attendance of department staff meetings and/or reading/initializing the minutesPerforms other duties as assigned by practice leadershipConsistent and reliable attendance including communication and attempts to find coverage when issues prevent attendanceReviews material submitted by Health Plans and Managed Care Organizations to gain full understanding of benefit coverage and precertification/authorization, if appropriateQuality review procedures are followed to ensure accounts are brought to a timely and accurate resolution, if appropriateAdheres to Organization Code of Conduct and follows all applicable compliance policies and regulationsAbility to prioritize and perform multiple duties, simultaneouslyAbility to take ownership of work and follow up on responsibilitiesSpeaks, spells, and writes clearly, concisely and to the pointConsistently follows Patient Identification IDD by using two patient identifiers related to the registration processPatient Identification Manager will be alerted if duplication medical record numbers are identifiedProper name format is consistently followedManaged care organizations are correctly identified and selected as part of the registration process, if appropriateTimely modifications of registrations are done in order to ensure billing of encounters.Uses independent judgment when necessary, if appropriateAssists Practice Manager with patient complaints related to billing invoices, if appropriateAppropriately refers patients/staff with issues/concerns to the Practice ManagerPerforms Service Recovery when necessarySeeks ways to improve quality of services providedHas 100% of iCare, employee updates and any other in-services meetings and training as assignedMaintains documented evidence of continuing educationParticipates in multidisciplinary problem-solving groups, in-service and departmental, practice and hospital meetings as requested; may participate as PM's proxyWorks safely and follows all safety policies; reports incidents or hazards immediatelyFollows all hand hygiene protocolsStrong knowledge of departmental policies, procedures and work flowsInsurance verification and precertification is performed prior to elective inpatient admission to ensure accounts are secured upon admission, if appropriateMonitors overtime of staff and alerts supervisor, manager and employee of any overtime listed, if appropriateFor all other non-scheduled inpatients, insurance verification and precertification is performed within 24 hours of admission or by the end of the business day to perform due diligence on accounts that admitted the previous day, if appropriateNames, dates, and times of conversations with businesses, insurances, managed care organizations, Utilization Review, and patients are documented, if appropriateInsurance verification and precertification is performed on high dollar outpatient areas to ensure reimbursement, if appropriateUnderstands the implication both clinically and financially of registration errors and the impact on the organizationReferral calls are made to PCP for Managed Care patients, if appropriateCorrect insurance is identified and selected when appropriate within the registration fields, if appropriatePolicy numbers are entered correctly into the registration fields, if appropriateEnsures that referral authorization numbers are submitted to Patient Account Services in a timely manner and understands the implications if this is not done, if appropriateFinishes work on time 95% of the time, avoiding overtimePrepares billing sheets and codes invoices prior to sending to Accounts Payable, if appropriateCollects payments (cash, co-payments, cash, checks and other forms of payment for services rendered; reconciles cash drawer/journal per Organization policy; promptly secures/delivers the cash deposits in the designated safe or other designated area for transit to the Fiscal Services Department, if appropriateOversees daily revenue reports and charge reconciliation, if appropriateHandles payroll in API and tracks time and attendance and reports to manager, if appropriateAct in a cost-conscious manner and sets an example for others in use of office suppliesPromotes services at Northern Light HealthMeets continuing education requirements set forth by the practiceSeeks opportunities for enhancement of skillsAssists with answering questions and directing practice staff to appropriate resourcesAttends 100% of employee updates.Other Information:Competencies and SkillsBehaves with Integrity and Builds Trust: Acts consistently in line with the core values, commitments and rules of conduct. Leads by example and tells the truth. Does what they say they will, when and how they say they will, or communicates an alternate plan.Cultivates Respect: Treats others fairly, embraces and values differences, and contributes to a culture of diversity, inclusion, empowerment and cooperation.Fosters Accountability: Creates and participates in a work environment where people hold themselves and others accountable for processes, results and behaviors. Takes appropriate ownership not only of successes but also mistakes and works to correct them in a timely manner. Demonstrates understanding that we all work as a team and the quality and timeliness of work impacts everyone involved. Practices Compassion: Exhibits genuine care for people and is available and ready to help; displays a deep awareness of and strong willingness to relieve the suffering of others.EducationRequired High School Diploma/General Educational Development (GED)Working ConditionsNeed to drive to perform responsible duties. Lifting, moving and loading less than 20 pounds. Prolonged periods of sitting.