Patient Service Rep I

Northern Light Eastern Maine Medical CenterDepartment: Primary Care - PediatricPosition is located: Northern Light Pediatric Health CenterWork Type: Full TimeHours Per Week: 40.00Work Schedule: 9:00 AM to 5:30 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 I is a supporting position and is responsible for a variety of activities related to patient in-take and care. The Patient Services Representative I is generally the first point of contact for patients entering the practice. 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 reconciliation, chart preparation and other duties as assigned.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 communication.Uses 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 requested. Attends all practice staff meetingsGreeting patients, having patient(s) sign appropriate forms/consents.Verifying and updating demographic/insurance information on all encounter forms and systems per protocol. Notifying registration of changes if applicable.Demonstrating mastery of appropriate practice software and registration tool protocols.Scheduling 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 protocol.Retrieving and processing messages per protocol.Assists with orientating and training/cross-training of new and established employees as assigned.Provides coverage in other areas as neededEffectively covers other support positions (e.g. phones, insurance referrals, scheduler) as neededDemonstrates mastery of appropriate scheduling and registration protocols, if appropriateTakes ownership for determining customer' needs and offering assistanceSchedules outpatient testing per orders/referral process, inputs appointment dates and times into patient EMR, if appropriateRecognizes problems and offers constructive solutionsPerforms other duties as assigned by practice leadershipReviews 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 appropriateAbility 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, if appropriateUses independent judgment when necessaryAssists Office Manager with patient complaints related to billing invoices, if appropriateAppropriately refers patients/staff with issues/concerns to the direct supervisorPerforms Service Recovery when necessaryHas 100% of iCare, employee updates and any other in-services meetings and training as assignedMaintains documented evidence of continuing educationInsurance verification and precertification is performed prior to elective inpatient admission to ensure accounts are secured upon admission, 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 organization, if appropriateReferral 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 overtime.Prepares 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 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 audit/cash control, if appropriatePromotes 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 ConditionsPotential exposure to abusive and/or aggressive people. Work with computers, typing, reading or writing. Lifting, moving and loading 20 to 30 pounds. Prolonged periods of sitting. Prolonged periods of standing. Prolonged periods of walking.