Patient Service Representative (PSR) – AdvocateCare

Major Responsibilities:

Patient Reception (Check-In Process). Provision of efficient, high-quality service to patients who arrive for appointments in person or who telephone requesting appointments or information on tests and procedures, bills and charges, referrals and other matters. Time of Service collection for prior balances and/or converting insurance for fee-for-service patients or collection of co-payments for HMO patients.

1.    Makes patients and visitors feel welcome through appropriate communication techniques.

2.    Makes patients and visitors feel welcome through appropriate communication techniques.

3.    Upon check-in, greet each patient with the appropriate salutation, eye contact, and a smile. Verify demographics having patients tell you their current address and telephone number (or verify/sign/date PIV Form). Review and copy insurance cards as appropriate, and send the information to the designated Business Office.

4.    Accurate and complete registration of new patients, verifying demographics and insurance information. Verifies patient benefit plans and eligibility. Identifies patient’s responsibility, copies insurance.

5.    Directs/escorts patients or visitors to appropriate waiting area.

6.    Provides new patients with a Welcome Packet and tour of Center.

7.    Coordinates scheduling of patient appointments including walk-in appointments (by phone and in-person) accurately and efficiently following Advanced Access Guidelines.
8.    Assists patients with all requests, such as, return to work/Worker’s Compensation statements, shot records and premarital certificates.

9.    Resolves a variety of patient questions, including HMO referrals, billing queries about services and test results. Refers complex issues to supervisor, or a clinical staff member, as appropriate.

10. Schedules future appointment requisitions, laboratory tests, radiology procedures and other diagnostic tests as needed. May coordinate with appropriate sections of hospital and/or outpatient admissions and surgery coordinator.

Billing Services. Ensures the collection of co-payments and prior balance amounts using Time Of Service (TOS) standards and scripts. Use the daily TOS Opportunity Report to prepare for collections that day. Documents reasons for non-payment of either co-payment or outstanding balance in the comments section of IDX.

1.    Reports compliance matters to supervisor/COD as identified.

2.    Follows up with provider for assurance of accurate code assignment.

3.    Follows appropriate channels for assurance of correct code assignment and timely entry for billing.

4.    Works with the Financial Counselor/Administrative Supervisor to answer patient account questions, seeks solutions to billing questions, resolve issues and/or refer for payment plans to be established.

5.    Works in partnership with SRCO to solve patient account problems and update insurance information.

6.    Prints and reconciles daily batch report for errors, incomplete transactions or variances and takes action as necessary.

7.    Co-pay collection rate must be a minimum of 90% collected each day.

8.    An attempt must be made to collect prior balances: patients who do not pay prior balances must be directed to the Patient Financial Counselor or Administrative Supervisor for payment arrangements. A batch report must accompany each deposit, (overage and shortages must be explained). Reconciles money received to money posted. Researches and documents variances. Prepares deposit slips. Batches money and deposits it in the vault. Balance credit card machines each night if you take a credit card payment. Place a “terminal total” receipt with your co-payments. All batches must be closed at end of shift. Ensure that you do have any open batches at the end of the month. Follow full compliance with bank and batch procedures. Accurate entry of all patient encounter tickets Documents all discrepancies identified in IDX system including patient insurance coverage and identification numbers and submits corrections to SRCO. Works in conjunction with the center management team to accomplish the established center TOS and organizational goals. Works in conjunction with center management team to assist patients in the conciliation of any issues or concerns. Educates patients about prior balances by utilizing the IDX system. Maintains awareness of new trends or changes in insurance coverage and coding information.

9.    Communication. Effective communication with all patients and visitors in a timely and professional manner.

10. Transfer phone calls to the appropriate extension and announce the call. If the extension has voicemail, explain to the caller that they may leave a message if their call is not answered. If you need, place the caller on hold, ask their permission and wait for their response before doing so. Sends, receives and distributes communications accurately based on practice protocol (includes pagers and faxes). Holds conversations regarding patient medical information away from other patients and co-workers. Maintains patient privacy and confidentiality.

Notifies the HELPDESK of any telecommunication of IDX system problems and the Practice Manager. Ability to troubleshoot printer, fax machine and copier problems, which includes changing of toner and/or cartridge.

1.    Utilizes Service Breakthrough tools to ensure all patients are given the highest quality customer service.

2.    Effective communication with all patients, visitors and associates.

3.    When coming in contact with patients and/or clinical staff, use scripts at all times.

4.    Advocate Health Center Telephone Standards must be used each time you answer your telephone or the switchboard. Answer all telephone calls with courtesy by the third ring.

5.    Coordinates service with fellow associates to ensure that patient wait time does not exceed 20 minutes.

6.    Communicates unexpected delays in service at regular intervals.

7.    Collaborates or works closely with other departments or disciplines to ensure that patients’ needs are met or addressed.

8.    Approach individuals who appear to need assistance and give them help with a smile. If you are unable to assist them, direct them to the appropriate person who can help them.

9.    Answers incoming telephone calls, accurately determining the appropriate recipient of the call or message and transferring them promptly and appropriately.

Provider Scheduling. Coordination of physicians’ daily schedules to ensure appointment availability. Accommodation of physician scheduling changes and patient notification in an efficient and timely manner.

1.    Adheres to Advanced Access and overbooking scheduling protocol, along with monitoring physicians’ schedules.

2.    Cancels provider schedules in IDX.

3.    Contacts all patients affected by provider scheduling changes to reschedule appointments.

Education/Experience Required:

·         High school diploma or equivalent.

·         2-3 years experience in ambulatory medical office setting.

·         Experience handling difficult callers/customers/patients.

·         Cashier and computer skills preferred.

Knowledge, Skills & Abilities Required:

·         CRT/PC experience in a customer service setting.

·         Working knowledge of the IDX System preferred.

·         Ability to solve problems posed by callers leaving messages, seeking referrals, appointments, billing issues and clinical information.

·         Ability to meet, greet and use positive customer service skills in working with patients, customers.

·         Good communication skills.

Physical Requirements and Working Conditions:

·         Ability to function in a high volume, multiple-task environment.

·         Exposure to ill patients.

·         Possible travel to other sites or to ancillary settings for training programs and/or temporary assignments.

·         Bilingual preferred

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.