Patient Service Representative/Scheduler

3 weeks ago

Naples, United States NCH Healthcare Full time

About NCH

NCH is an independent, locally governed non-profit delivering premier comprehensive care. Our healthcare system is comprised of two hospitals, an alliance of 700+ physicians, and medical facilities in dozens of locations throughout Southwest Florida that offer nationally recognized, quality health care.

NCH is transforming into an Advanced Community Healthcare System(TM) and we're proud to: Provide higher acuity care and Centers of Excellence; Offer Graduate Medical Education and fellowships; Have endowed chairs; Conduct research and participate in national clinical trials; and partner with other health market leaders, like Hospital for Special Surgery, Encompass, and ProScan.

Join our mission to help everyone live a longer, happier, healthier life. We are committed to care and believe there's always more at NCH - for you and every person we serve together.

JOB SUMMARY

  • The Patient Service Representative/Scheduler provides a vital link in the chain of Quality of Care; the PSR supports the clinic by serving as first point of contact to patients and completing all administrative tasks associated with scheduling, patient interaction, and insurance verification.
  • The PSR/Scheduler is responsible for obtaining all information to ensure verification and authorization of services provided can be obtained. Scheduler duties will vary based on the business unit or office associated with the Scheduler role.

ESSENTIAL DUTIES AND RESPONSIBILITIES

  • Fulfills patient care responsibilities as assigned, which includes checking schedules and organizing patient flow.
  • Recognizing any changes in patient's condition upon presentation in the office and conveys the changes to clinical team members or providers.
  • Collects patient history form upon intake, which includes current medications, allergies, symptoms, etc.
  • Obtains required personal information necessary to identify all new and existing patients and the correct demographic and preliminary financial information to enable the creation of new patient medical records and the pre-processing of required authorizations / pre-certifications before the appointed visit.
  • Prioritizes all insurance coverage - primary / secondary / tertiary etc. Enter properly into demographic record.
  • Accurately uses appropriate search methods (DOB, SSN, etc.) to ensure the correct patient is identified.
  • Verifies patient information on file is accurate and updated as per company standards; updates patient data when insurance, address, or other information has changed.
  • Verifies patient registration profiles each time patient comes for a visit. Edits patient registration profiles when necessary.
  • Obtains all consents for treatment, including forms for the release of medical information and patient's acceptance of financial responsibility for all services rendered, when applicable.
  • Completes required Medicare questionnaires (ABN Forms) for appropriate patients and tests under Medicare guidelines.
  • Accurately and completely processes physician's referrals and orders and enters the tests into the Electronic Medical Record (EMR); should be well versed with templates and ordering.
  • Maintains patient clinical forms (ie: prescriptions, laboratory requisitions, etc) for patient pick-up.
  • Ensures respective patient medical record information, all collected forms, and photocopied documentation, are placed in the EMR in the proper location.
  • Schedules appropriate new and follow-up medical/surgical appointments and radiological testing procedures for respective physician sites, based on the patient's specific needs.
  • Announces scheduled and non-scheduled (if appropriate) patients to the clinical staff.
  • Confirms and reminds patients of scheduled appointments in accordance with the clinic's procedures.
  • Gives patients standardized preliminary clinical instructions and directions in preparation for a scheduled office visit, radiological test, or procedure as needed.
  • Collects and deposits all required and mandatory insurance co-payments and deductibles according to specific protocols (i.e.: time of service collection policy).
  • Monitors patient waiting time and relays information regarding delays to patients and family members.
  • Ensures benefits & eligibility has been verified for all scheduled patients.
  • Accurately enters charges for all services performed.
  • Accurately enters payment information for each payment collected.
  • Produces appropriate reports to reconcile charges and payments with data entered into EMR.
  • Prepares daily close report detailing reconciliation, prepares bank deposit & submits daily close report to accounting for reconciliation with bank.
  • Must be able to communicate with staff, supervisors, peers, and associates and maintain a positive working environment when manager is not present. Functions as a liaison between our physician's office(s), referral physicians, and ancillary services and the patients.
  • Fields questions by both physicians and patients regarding codes, charges, etc. PSR understands when questions require further explanation by Practice Manager or Biller.

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