Patient Services Representative

Patient Services Representative

Patient Services Representative, MIT Medical

Reports To: Supervisor, Admin Clinical Operations

Position Overview: 

By exhibiting excellent customer service, the Patient Services Representative, is responsible for patient flow and appointment scheduling. This highly visible position has extensive patient contact, both in person and by telephone. Typical duties include, but are not limited to:

  • Front desk (check in, collecting co-pays, obtaining accurate insurance eligibility information, etc.) and administration (phone calls, data entry, insurance reviews, filing, etc.).
  • Schedules patient encounters (appointments) and procedures to coordinate within and across providers, service areas, and institutions.
  • Collaborates by effectively communicating with referral providers and practices to facilitate management of complex patient issues.
  • Provides positive and effective customer service that supports departmental operations.
  • Greets and directs patients, families, and visitors 

Principal Duties and Responsibilities:   

  • Greets all patients and family members in a professional and courteous manner.
  • Verifies all demographic and insurance information, making changes as necessary.
  • Ensures copy of proof of insurance card is taken for all encounters at the time of patient check in.
  • Collects co-payments and maintains an accurate cash log of all dollars collected.
  • Reconciles payments and prepares deposits providing an accurate accounting of funds. Provides accurate record of transactions within appropriate systems. Facilitates and directs communication to Billing Office when questions of payment ability arise.
  • Maintains a working understanding of all health insurance plans, financial services, and self-pay resources, specifically focusing on those sponsored by MIT and Medicare. Appropriately refers patients to Health Plans Member Services when questions arise regarding benefit and referral issues. Maintains basic knowledge of medical terminology and ICD10 coding
  • Rotates through the check in and telephone roles using predetermined frequency.
  • Manages both inbound and outbound phone calls, emails, and/or other standard patient inquires by answering, screening, and routing inquiry as dictated by service area workflows.
  • Record messages in appropriate tracking log(s) and forward said messages as per standards for triage and/or other urgent information or services.
  • Respond to requests for routine information or assistance within scope of knowledge and authority. Triages and manages more complex telephone calls, utilizing courteous customer service skills. Initiating call for emergency services as required.
  • Answers all incoming calls that arrive at the service desk for clinicians, takes messages, and routes appropriately.
  • Notifies provider or takes steps to locate covering providers for patient emergencies.
  • Uses sound judgment in triaging patients in other areas when necessary.
  • Assists service area clinicians in returning telephone calls, calling in prescriptions, and informing patients of results as requested.
  • Prepares correspondence for patients and physicians when required.
  • Rotates through the check in and telephone roles using predetermined frequency.
  • Maintains computerized patient appointment schedule.
  • Working directly with each patient (or their HIPAA approved representative), schedule and record all encounter appointments, communicating patient confirmation and reminders as established by service area standards.
  • Schedule emergency sick visits as outline in service area protocols so that patients are seen by their primary care provider or a provider within their service area while also minimizing the need to route patients to Urgent Care
  • Coordinates patient visits with other MIT Medical Specialties, diagnostic testing, and/or off-site practices to ensure that patients are seen in a timely manner. Communicates with primary care provider or designee when necessary to escalate scheduling roadblocks.
  • Processes all necessary referrals and follows up on all insurance questions and inquiries as needed.
  • Verify, record and process all patient demographics, insurance / payment or other information pertinent to the referral appropriately to ensure that patient information and needs are accurately met.
  • Provides support and information to clinicians to problem solve and manage complex administrative patient issues.
  • Opens, sorts, and processes all incoming and outgoing mail.
  • Assists with responds to information inquiries, patient requests, and medical record copies as requested.
  • Maintains office supplies and stock and communicates all stocking needs to office practice supervisor.
  • Provides cross coverage for other Service Area staff members for absences, vacations, etc. and during variations in workflow, as needed.
  • Other duties as assigned.

Minimum Required Education and Experience:

  • High school diploma or GED equivalent required.
  • Minimum two years of previous experience such as customer service or administrative role required. Prior experience in a health care setting a plus.
  • Ability to perform multiple tasks simultaneously.
  • Effective telephone manner and ability to communicate with patients, clinicians, and other professional staff in pleasant, calming, and diplomatic manner.
  • Strong organizational and follow through skills.
  • Math skills; ability to add, subtract, multiply, and divide with accuracy.
  • Ability to work independently or within a team environment.
  • The ability to work with diverse internal and external constituencies.

Preferred Education and Experience:

  • Associates degree or higher in Communications, Business, or other relevant field.
  • Knowledge of medical terminology
  • Two years of experience in a busy medical practice setting.
  • Knowledge of pre-admission and pretesting requirements helpful.
  • Working knowledge of insurance regulations and form completion.
  • Ability to be trained in CPT and ICD10 coding. Knowledge of billing system helpful.
  • Self-Starter and able to work independently upon training completion
  • Insurance verification experience; knowledge of deductible / co-pays

Job Number: 22561
Grade Level: 4

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