Patient Services Representative

Title: Patient Services Representative & Support Staff

Classification: Hourly-Non-Exempt

Department: Patient Services

Reports to: Front Office Supervisor

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SUMMARY OF RESPONSIBILITIES:

• In conjunction with the Medical department, the Patient Services Representative organizes the daily appointments for services of children in accordance with their designated treatment plan.
• The Patient Services Representative has excellent customer service and communications skills, demonstrates empathy, is people focused, works in a fast-paced environment, able to multi-task, adapts well to change and is resourceful while meeting deadlines
• Obtains and verifies patient and family identification as well as other documents (ex, insurance, financial info). Enters appropriate information into the system.
• Appropriately communicates with team members and management.
• Provides and assists patients and families with CRIT-USA´s services.
• Schedules patient appointments.
• Responsible for reviewing patient insurance to ensure authorizations are obtained for all patients prior to appointments.
• Familiar with insurance platforms to acquire authorizations and to manage claims.
• Experience with obtaining and verifying patient and family identification as well as other documents (insurance, financial info). Entering appropriate information into the system.
• Ensures to meet deadlines, create and follow work plans, while maintaining flexibility.
• Ensures patients and families adhere to CRIT-USA's rules and regulations.
• Transmits CRIT Mission/Vision/Values to patients and families.

ESSENTIAL FUNCTIONS:

• Greet patients and assist them in checking in and out.

• Verify patient/family demographic information and enter this information in the electronic health record, to include scanning, filing, purging, and checking for or obtaining required missing documents.

• Confirm that patient's insurance has been verified, prior to appointments.

• Perform administrative duties including answering/returning calls, filling, scheduling appointments, contact families, following up with inquiries.

• Assist families in filling out patient history forms, consent forms, and payment contract forms, when necessary.

• Review patient accounts, identify delinquent accounts, and collect overdue payments.

• Update and verify patient information at every visit.

• Answer, investigate, and/or direct patient inquiries or complaints to the appropriate medical staff member.

• Interact with children, their families and special mobility devices on occasion.

• Interview and assist patients with authorization documents, as appropriate.

• Communicate directly and consistently with patients regarding their financial responsibility.

• Process rejections and follows-up with insurance carriers on unpaid claims. Monitors claims for missing information, authorization numbers.

• Verify patient/family demographic information and enter this information in the electronic health record, to include scanning, filling, purging, and checking for or obtain required missing documents.

• Assist with administrative functions including answering/returning calls, scheduling appointments, contact families, following up inquiries.

• Assist with coverage of different Patient Services roles, as needed.

• Complete projects, as assigned.

• Serves and protects CRIT-USA's community by adhering to professional standards, policies and procedures, federal, state, and local requirements.

• Enhance patient advocacy and CRIT-USA's reputation by accepting ownership for accomplishing new and different requests; exploring opportunities to add value to job accomplishments.

• Ensure the protection of confidential information in accordance to HIPAA guidelines as well as organizational policies.

• Other duties as assigned.

JOB SPECIFICATIONS:

A. KNOWLEDGE/SKILLS:

• Experience in customer service, preferably in health care setting.

• Knowledge of pediatric rehabilitation.

• Flexible, team player attitude, rotates through lobby desks, front offices, call center, or train.

• Must be able to interpret physician indications to schedule appointments as appropriate.

• Maintain files and/or records for the purpose of ensuring the availability of information as required for reference or compliance.

• Excellent communication and writing/documentation skills, including updating patient account with attention to detail.

• Must possess specific knowledge-based competencies required to satisfactorily perform the duties including pertinent codes, policies, regulations and/or laws.

• Skill in operating a computer and other office equipment.

• Planning and organizing ability.

• Problem solving ability.

B. ATTITUDE:

• We love whom we serve

• We forge a culture of justice, rights and inclusion

• We are faithful to our mission

• We are responsible and live our work with passion

• We generate creative ideas and put them into practice

• We are resourceful and committed to sustainability in all our actions

• We are generous, committed to transforming the lives of the families we serve regardless of their insurance or ability to pay

C. EDUCATION/CERTIFICATIONS:

• High school diploma or equivalent.
• Minimum of 3 years of Customer Service and/or prior experience in medical, or hospital setting.
• Excellent computer skills, including experience with health care patient databases, patient scheduling software, Microsoft Outlook, messaging service.
• Must be able to tactfully handle Human Relations obstacles.

D. GENERAL INFORMATION:

Bilingual in Spanish preferred.

• Minimal hazards in a general office working condition as long as safety is followed in keeping power cords fastened to floors, walkways clear, filing cabinets closed, chairs

CRIT job description does not list all the duties of the job. You may be asked by your supervisors or managers to perform other duties. You will be evaluated through the CRIT performance evaluation system and part of that evaluation will be based upon your performance of the tasks listed in the CRIT job description.

CRIT has the right to revise this job description at any time. The job description is not a contract of employment, and either you or the employer may terminate employment at any time, for any reason.