Patient Service Representative -DAYS-Full Time

Full Time
Dayville, CT 06241
Posted
Job description
Patient Services Representative
Internal Medicine Department
DKMG-Dayville, Ct Location
JOB TITLE:
Patient Services Representative
DEPARTMENT:
DKMG


REPORTS TO:
Practice Manager
PAY GRADE:
3


SUPERVISE DIRECTLY:
0
CLASSIFICATION:
Non-Exempt


SUPERVISE THROUGH SUBORDINATES:
0
TOOL NAME:
Clerical


DATE:
1/25/23
JOB CODE:
381505PR12523



JOB SUMMARY

The PATIENT SERVICES REPRESENTATIVE is a multi-tasking position that consists of all front-end functions including customer service, telephone management, scheduling, registration, copay collections, time of service account management, coding review, charge entry, and appropriate cash and end-of day closure procedures. The PSR will ensure that all provider schedules are appropriately populated, telephones are responded to according to established protocols, and complete registration information is captured prior to, or during each patient visit. In this role, the PSR will perform appropriate and timely charge entry, if not performed electronically through an EMR, for all patient visits including a review of encounters and recommendations for appropriate procedural coding, manage cash drawers according to established protocols, post cash to patients accounts, manage patient responsible account balances at the time of service, and correct assigned claims edits for expedient submission to carriers.

ESSENTIAL RESPONSIBILITIES:


Responsible for collaborative interaction with patients, physicians, other staff members and management, patient satisfaction and accurate processing of all front-end functions are integral to the success of this individual.


Plans and directs pre-verification of patient insurance, registration, billing and collections, and data processing to ensure accurate patient billing and efficient account collection.


Appropriately responds to patient inquiries via telephone following established protocols


Follows procedures for verification of patient demographics information including insurance verification prior to the patient visit for all pre-scheduled patients


Utilizing established protocols, appropriately schedules patients whenever possible, at the patients’ convenience for physician visit


Registers all patients at each visit utilizing established policies for the capture of complete and up-to-date patient and insurance information. Receives and documents in the information system patient responsible payments including co-payments, past balance payments, and time of service patient-responsible charges


Check-out each patient via established policies, including charge entry for current visit if appropriate, scheduling of future appointments, facilitation of ancillary procedures as necessary, and provides for the patient a receipt for services rendered


Will consistently perform surgical and other hospital charge entry functions as assigned and collaborate with providers regarding appropriate coding procedures


Following clinic policy, appropriately reconciles cash and charge batches, balances cash drawer, prepares deposits, and reconciles charges to visits and the co-pay holding file with an accurate balance for each opened batch


As assigned, processes all referral requests by physicians and patients within a timely manner and according to clinic procedure


As assigned, processes and maintains medical records in accordance with records protocols

SKILLS AND ABILITIES:
  • Good physical and mental health, able to assist with heavy lifting and capable of working under pressure.
  • Ability to perform detailed assignments, work accurately, follow directions and assess priorities.
  • Accurate and timely processing of all front-end functions (>97% )
  • Excellent telephone skills as measured by random audits, and the absence or presence of patient complaints
  • Attention to active collections of copayments and patient responsible balances
  • Copayments collected versus expected at > 90%
  • Past balance collected at time of service > 40%
  • Adherence to established attendance and tardiness policies
  • Demonstrated excellence in customer service
  • Demonstrated competencies in charge entry and clean claims submission
  • Demonstrated competency with medical procedural coding (CPT/ICD9)
  • Must demonstrate the ability to interact with personnel of all levels within the organization and work within a multi-disciplinary team environment.
  • Demonstrate excellent interpersonal skills, customer orientation and an outgoing and pleasant demeanor
PHYSICAL DEMANDS:
Sedentary Work: Exerting up to ten pounds of force occasionally and/or a negligible amount of force frequently to lift, carry, push, or pull, or otherwise move objects. Involves sitting most of the time but frequently involves walking or standing activities for brief to lengthy periods of time.
ENVIRONMENTAL CONDITIONS:
Inside: Protection from weather conditions but not necessarily from temperature changes. Activity level may be high and work stressful. Potential exposure to communicable diseases and hazardous substances.
LANGUAGE, MATHEMATICAL AND RESONING DEVELOPMENT:
Language
Reading: Read and understand instructions, safety rules, etc.
Writing: Write sentences using cursive style and proper punctuation, and employing adjectives and adverbs.
Speaking: Speak clearly and distinctly with appropriate pauses and emphasis, correct pronunciation, variations in word order, using present, perfect and future tenses.
Mathematical
Add, subtract, multiply and divide all units of measure. Perform the four operations with like common and decimal fractions. Compute ratio, rate, and percent. Draw and interpret bar graphs. Perform arithmetic operations involving all American monetary units.
Reasoning
Apply common sense understanding to carry out instructions furnished in written, oral or diagrammatic form. Deal with problems involving several concrete variables in or from standardized situations.
RELATIONSHIPS TO DATA, PEOPLE AND THINGS:
Data
Coordinating: Determining time, place and sequence of operations or action to be taken on the basis of analysis of data; executing determination of and/or reporting on events.
People
Serving: Attending to the needs, requests or the expressed or implicit wishes of people. Immediate response is involved.
Things
Manipulating: Using body members, tools or special devices to work, move, guide or place objects or materials. Involves some latitude for judgment with regard to precision attained and selecting appropriate tool, object or material, although this is readily manifest.
QUALIFICATIONS:
Education:
  • Completion of a high school diploma.
  • College level courses preferred but not required.
Experience:
  • Demonstrated competency with medical procedural coding (CPT/ICD9)
  • At least 4 years of relevant front-desk and customer related experience, preferably within a healthcare environment
  • Demonstrated competencies with cash controls, and typing skills at a minimum of 40 WPM.
  • Prior experience and demonstrated competence with patient or customer information systems
JOB DUTIES/RESPONSIBILITIES:
  • Demonstrate behaviors consistent with the practice’s mission, which is: To meet the health needs of our community through our core values of clinical quality, customer service, fiscal responsibility and local control.
  • Demonstrate competency in utilizing resources to accommodate cultural needs of patients and customers such as dietary, religious and language needs.
  • Must be able to maintain confidentiality in a professional manner.
  • Participate in continuous quality improvement activities.
  • Remain flexible in work schedule in order to provide the most effective and efficient support for the practice and Medical Group’s mission.
  • Demonstrate ability to communicate and interact with staff and physicians.
  • Demonstrate knowledge of all practice and Medical Group policies relevant to the performance of their responsibilities.
  • Demonstrate knowledge and application of principles of fire safety, hazardous communication program, infection control, and general safety.
  • Demonstrate ability to communicate and interact with patients and customers of all ages.
  • Plans and directs pre-verification of patient insurance, registration, billing and collections, and data processing to ensure accurate patient billing and efficient account collection.
  • Appropriately responds to patient inquiries via telephone following established protocols
  • Follows procedures for verification of patient demographics information including insurance verification prior to the patient visit for all pre-scheduled patients
  • Utilizing established protocols, appropriately schedules patients whenever possible, at the patients’ convenience for physician visit
  • Registers all patients at each visit utilizing established policies for the capture of complete and up-to-date patient and insurance information
  • Receives and documents in the information system patient responsible payments including co-payments, past balance payments, and time of service patient-responsible charges
  • Appropriately establishes patient arrival for appointment and notifies clinical personnel of patients arrival
  • Check-out each patient via established policies, including charge entry for current visit if appropriate, scheduling of future appointments, facilitation of ancillary procedures as necessary, and provides for the patient a receipt for services rendered
  • Shall utilize coding expertise for charge entry functions
  • Will consistently perform charge entry functions as assigned
  • As necessary, will collaborate with providers regarding appropriate coding procedures
  • Following Medical Group policy, appropriately reconciles cash and charge batches, balances cash drawer, prepares deposits, and reconciles charges to visits and the co-pay holding file with an accurate balance for each opened batch
  • As assigned, processes all referral requests by physicians and patients within a timely manner and according to clinic procedure
  • As assigned, processes and maintains medical records in accordance with records protocols
  • Performs other duties as assigned

Approved by ___________________________________________________________Date:__________
Department Head
Employee Signature _____________________________________________________Date:__________

PATIENT SERVICES REPRESENTATIVE
ADDENDUM A
JOB CODE:
81502- Grade 3

For the Patient Services Representative that performs cross coverage as a Medical Assistant as a secondary position.
JOB SUMMARY
Under general supervision of the Office Manager in an outpatient clinical setting, provides initial patient triage, registration, patient intake services, assists with direct patient care, and performs specialized medical procedures of a routine nature, as dictated by established clinical protocol.
Performs and facilitates the smooth functioning of the patient care flow.

ESSENTIAL RESPONSIBILITIES:



Assists with direct patient care procedures and related tasks; checks in patients, assists in obtaining patient histories, takes vital signs, prepares charts, and assists with medical examinations.


Performs routine specialized procedures, which could include sterile dressing changes under established protocols.


Maintains stocks of medicines and medical supplies as necessary.


Educates and advises patients on specified medical issues within established parameters.


Approved by ____________________________________________________Date:__________
Department Head

Employee Signature _______________________________________________Date:__________

PATIENT SERVICES REPRESENTATIVE
ADDENDUM B
JOB CODE:
81506 – Grade 5

q ALL PRACTICES: Lead Patient Services Representative
JOB SUMMARY
The Lead PSR assists the Office Supervisor/Practice Manager with the staff and daily operations of the front office. The Lead PSR provides a presence for staff to facilitate and insure that the front office is operating optimally.

ESSENTIAL RESPONSIBILITIES:



Proficient at the process for verifying client's demographic information and insurance eligibility. Understand and assist in scheduling patient appointments according to departmental policy. Assists with answering numerous phone calls, takes accurate messages, documents directions and information given. Directs calls to appropriate personnel. Adept at using essential programs on a personal computer and variety of office machines.


Facilitates the collection of appropriate co-pays at the beginning of appointments. Is able to process the end of day co-pay receipts. Responsible for ensuring the daily bank deposit and reconciliation is complete.


Oversee scheduling of patient appointments for daily and future visits. Works to maximize provider schedules. Has appropriate recall systems in place for future appointments. Appropriately builds and adjusts provider templates in collaboration with the office supervisor


Responsible for the support of PSR staff and oversight of daily work flow. Responsible for providing feedback at annual evaluations of office staff. Monitors (and reports) staff absenteeism and job performance. Assists office supervisor in creating and coordinating the monthly PSR work schedules to ensure the office is appropriately staffed. Determines feasibility of meetings, vacation and time-off requests.


Order non-clinical office supplies Take an active role in the cost containment of expenses and ways to maximize revenue


Assist in/complete special projects as assigned.

SKILLS & ABILITIES

  • Good interpersonal and leadership skills.
  • Good verbal and reasoning skills.
  • Highly motivated with the ability to work in a team environment.
  • Multi-tasking skills required.
  • Hands on experience with computers.
  • Good telephone techniques.
  • Ability to deal with difficult as well as pleasant clients.
  • Good physical and mental health.
  • Ability to communicate effectively.
  • Knowledge of third-party billing regulations and Medicare guidelines
  • Must be accurate, dependable and adaptable.
  • Ability to plan and organize workload.

Approved by___________________________________________________________Date_________________
Department Head

Employee Signature_____________________________________________________Date_________________

JOB DESCRIPTION

JOB TITLE:
Patient Services Representative
DEPARTMENT:
DKMG
REPORTS TO:
Practice Manager
PAY GRADE:
3
SUPERVISE DIRECTLY:
0
CLASSIFICATION:
Non-Exempt
SUPERVISE THROUGH SUBORDINATES:
0
TOOL NAME:
Clerical
DATE:
3/2013
JOB CODE:
81505




JOB SUMMARY
The PATIENT SERVICES REPRESENTATIVE is a multi-tasking position that consists of all front-end functions including customer service, telephone management, scheduling, registration, copay collections, time of service account management, coding review, charge entry, and appropriate cash and end-of day closure procedures. The PSR will ensure that all provider schedules are appropriately populated, telephones are responded to according to established protocols, and complete registration information is captured prior to, or during each patient visit. In this role, the PSR will perform appropriate and timely charge entry, if not performed electronically through an EMR, for all patient visits including a review of encounters and recommendations for appropriate procedural coding, manage cash drawers according to established protocols, post cash to patients accounts, manage patient responsible account balances at the time of service, and correct assigned claims edits for expedient submission to carriers.

ESSENTIAL RESPONSIBILITIES:
Responsible for collaborative interaction with patients, physicians, other staff members and management, patient satisfaction and accurate processing of all front-end functions are integral to the success of this individual.
Plans and directs pre-verification of patient insurance, registration, billing and collections, and data processing to ensure accurate patient billing and efficient account collection.
Appropriately responds to patient inquiries via telephone following established protocols
Follows procedures for verification of patient demographics information including insurance verification prior to the patient visit for all pre-scheduled patients
Utilizing established protocols, appropriately schedules patients whenever possible, at the patients’ convenience for physician visit
Registers all patients at each visit utilizing established policies for the capture of complete and up-to-date patient and insurance information. Receives and documents in the information system patient responsible payments including co-payments, past balance payments, and time of service patient-responsible charges
Check-out each patient via established policies, including charge entry for current visit if appropriate, scheduling of future appointments, facilitation of ancillary procedures as necessary, and provides for the patient a receipt for services rendered
Will consistently perform surgical and other hospital charge entry functions as assigned and collaborate with providers regarding appropriate coding procedures
Following clinic policy, appropriately reconciles cash and charge batches, balances cash drawer, prepares deposits, and reconciles charges to visits and the co-pay holding file with an accurate balance for each opened batch
As assigned, processes all referral requests by physicians and patients within a timely manner and according to clinic procedure
As assigned, processes and maintains medical records in accordance with records protocols

SKILLS AND ABILITIES:
Good physical and mental health, able to assist with heavy lifting and capable of working under pressure.
Ability to perform detailed assignments, work accurately, follow directions and assess priorities.
Accurate and timely processing of all front-end functions (>97% )
Excellent telephone skills as measured by random audits, and the absence or presence of patient complaints
Attention to active collections of copayments and patient responsible balances
Copayments collected versus expected at > 90%
Past balance collected at time of service > 40%
Adherence to established attendance and tardiness policies
Demonstrated excellence in customer service
Demonstrated competencies in charge entry and clean claims submission
Demonstrated competency with medical procedural coding (CPT/ICD9)
Must demonstrate the ability to interact with personnel of all levels within the organization and work within a multi-disciplinary team environment.
Demonstrate excellent interpersonal skills, customer orientation and an outgoing and pleasant demeanor

PHYSICAL DEMANDS:
Sedentary Work: Exerting up to ten pounds of force occasionally and/or a negligible amount of force frequently to lift, carry, push, or pull, or otherwise move objects. Involves sitting most of the time but frequ

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