Patient Service Coordinator (PSC)

Major Responsibilities

• Works in conjunction with the supervisor and center management team to accomplish established department goals and organizational objectives for service excellence and time of service collections, as well as, other initiatives in an efficient manner.
• Coordinate the completion of encounter information, PIV sheet verification functions, time of services collection, assist with coordination of coding activities pertinent to the department, assists Administrative Supervisor with auditing the accuracy of entry of ICD-9-CM, HCPC, and CPT codes into the IDX system. Assists with monitoring data entry using TES initiatives and service excellence activities.
• Works with associates to ensure scripts are being used for service excellence, new patient information packets are distributed. Uses Service Excellence scripts and monitors compliance with standards, e.g. monitors service with fellow associates to ensure that patient wait time does not exceed 15 minutes.
• Delegates/distributes work assignments working with supervisor or in supervisor’s absence.
• Reconciles money received to money posted on a daily basis. Researches and documents variances with communication to supervisor.
• Coordinates the documentation of all discrepancies as identified in practice management system (IDX) including patient insurance coverage, identification numbers and demographic information.
• Ensure printing of PIV forms and documentation of changes in IDX or with Central Business Office.
• Ensures time of service opportunity reports are printed and distributed on daily basis along with printing of retro TOS report from priority day to monitoring collection opportunities. Discuss any variances with supervisor. Print individual batch summary reports, missing charge reports and TES next day reports to ensure complete charge capture of all encounters.
• Creates, edits, modifies and monitors physician schedules. Works with IDX Helpdesk to request changes to master schedule and assigns appointment change notification to Patient Service Representative.

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.
• Makes patients and visitors feel welcome through appropriate communication techniques.
• Display helpful, courteous customer service skills at all times. Adhere to all Service Breakthrough Standards scripts and service recovery.
• 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 Business Office.
• Adhere to the uniform policy including wearing of name badge on vest/blazer.
• Maintain a neat, clean work area, free of food. Keep all drinks out of patient’s view and away from equipment.
• Accurate and complete registration of new patients, verifying demographics and insurance information. Verifies patient benefit plans and eligibility. Identifies patient responsibility, copies insurance identification cards, and identifies insurance product types.
• Directs/escorts patients or visitors to appropriate waiting area.
• Provides new patients with Welcome Packet and tour of Center.
• Coordinates scheduling of patient appointments including walk-in appointments (by phone and in-person) accurately and efficiently following Advanced Access Guidelines. Assists patients with all requests, such as, return to work/Worker’s Compensation statements, shot records and premarital certificates. 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. Schedules future appointment requisitions, laboratory tests, radiology procedures and other diagnstic tests as needed. May coordinate with appropriate sections of hospital and/or outpatient admissions and surgery coordinator.

Communication

• Effective communication with patients and visitors in a timely and professional manner.
• Utilizes Service Breakthrough tools to ensure all patients are given the highest quality customer service.
• Effective communication with all patients, visitors and associates.
• When coming in contact with patients and/or clinical staff, use scripts at all times.
• 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.
• Coordinates service with fellow associates to ensure that patient wait time does not exceed 20 minutes.
• Communicates unexpected delays in service at regular intervals.
• Collaborates or works closely with other departments or disciplines to ensure that patients’ needs are met or addressed.
• Communicates/maintains excellent rapport with co-workers and other associates.
• 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. Answers incoming telephone calls, accurately determining the appropriate recipient of the call or message and transferring them promptly and appropriately. Transfers phone calls to the appropriate extension and announces 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 a caller on hold, ask for their permission and wait for their response before doing so. Sends, receives and distributes communications accurately based on practice protocol. (Includes pages and faxes). Hold conversations regarding patient medical information away from other patients and co-workers. Maintain patient privacy and confidentiality. Notifies the HELPDESK of any telecommunication or IDX system problems and the supervisor, manager and/or Operations Director. Ability to troubleshoot printer, fax machine and copier problems which includes changing of toner and/or cartridge.

Billing Services

• Reconciliation of patient accounts on a daily basis in an efficient and accurate manner. Ensures the collection of co-payments and prior balance accounts using Time of Service (TOS) standards and scripts. Uses 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.
• Reports compliance matters to supervisor/COD as identified.
• Follows up with providers for assurance of accurate code assignments.
• Ensures accurate data entry of all ICD-9-CM, CPT and HCPC codes in IDX.
• Follows appropriate channels for assurance of correct code assignment and timely entry for billing.
• 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.
• Works in partnership with Business Office to solve patient account problems and update insurance information.
• Prints and reconciles daily batch report for errors, incomplete transactions or variances and takes action as necessary.
• Process each encounter and post all charges correctly. Runs a missing charge report every two hours and at the end of the day. Researches and processes all encounters that appear on this report.
• Co-pay collection rate must be at a minimum of 90% collected each day. 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 payment. Place a “terminal total” receipt with your co-payments. All batches must be closed at the end of the shift. Ensure that you do not 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 submitted to Patient Service Representative or leave in bin within service specialist working in the department. Documents all discrepancies identified in IDX system including patient insurance coverage and identification numbers and submits corrections to Business Office. Works in conjunction with the center management team to assist patients in the conciliation of any issues or concerns. Educates patients about prior balances by utilizing the IDX system. Maintain awareness of new trends or changes in insurance coverage and coding information.

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.
• Adheres to Advance Access and overbooking scheduling protocol, along with monitoring physicians’ schedules.
• Cancels provider schedules in IDX.
• Contacts all patients affected by provider scheduling changes to reschedule appointments.

Education/Experience Required:

• High school diploma or equivalent.
• 2-3 years of 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 patients 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 (especially in Spanish and Polish).

If position has direct patient care or direct patient contact the following lifting requirement supersedes any previous lifting requirement effective 06/01/2015. Ability to lift up to 35 pounds without assistance. For patient lifts of over 35 pounds, or when patient is unable to assist with the lift, patient handling equipment is expected to be used, with at least one other associate, when available. Unique patient lifting/movement situations will be assessed on a case-by-case basis.

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.