Patient Service Rep
Company: Valley Medical Center
Location: Renton
Posted on: May 3, 2021
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Job Description:
VALLEY MEDICAL CENTER Job Description Clinic Network The position description is a guide to the critical duties and
essential functions of the job, not an all-inclusive list of
responsibilities, qualifications, physical demands and work
environment conditions. Position descriptions are reviewed and
revised to meet the changing needs of the organization. TITLE: Patient Service Representative ROLE: See criteria for Administrative Partner for generic job
duties AREA OF ASSIGNMENT: Outpatient Clinic RESPONSIBLE TO: Clinic Manager Prerequisites: High School Graduate or equivalent (G.E.D.) preferred. Demonstrates basic skills in keyboarding (35 wpm) and using a
personal computer in Windows 2000 or XP environment. Able to communicate effectively in oral and written form in
English language. Evidence of excellent communication skills both oral and written
including the ability to spell accurately and write legibly. Excellent customer service skills. Knowledge of medical terminology and abbreviations and can spell
and understand commonly used terms preferred. Float Pool: General Qualifications: Demonstrated ability to function effectively and interact
positively with patients, peers and providers at all times. Demonstrated ability to access, analyze and apply concepts
associated with protocol, policy and guidelines. Demonstrated understanding of agency compliance standards. Possess excellent customer service skills: the reception area. Ability to communicate and work effectively with the physical
and emotional development of all age groups. Neat and well-groomed appearance, business professional. Demonstrated ability to maintain a calm demeanor at all
times. Demonstrated ability to function effectively in an environment
where it is necessary to perform several tasks simultaneously, and
where interruptions are frequent. Demonstrated ability to successfully manage telephone
interactions. Demonstrated ability to speak, spell and utilize appropriate
grammar and sentence structure. a. Utilize multiple monitors in facilitation of workflow
management b. Scanning and electronic faxing capabilities c. Electronic Medical Records d. Business practice management system e. Preparation and printing of fee slips f. Preparation of patient chart TYPICAL PHYSICAL/MENTAL DEMANDS, ENVIRONMENT AND WORKING
CONDITIONS: Generic Job Functions: See generic job description for
Administrative Partner. Telephone Management: In order to serve the patient's needs successfully on the phone
a PSR needs to listen well and think quickly in order to execute
the patient's request. It's important to be patient, and keep the
tone of your voice positive and kind. Good organization is key to
navigating your way through the various computer programs while
trying to locate information for the patient. Calls are
continuously arriving in the call queue; the PSR is required to
work quickly, while still giving the patient enough time to voice
their questions and concerns. PSR's strive to utilize first call
resolve. If not, then the PSR will send a message to an
MA/facilitator for assistance. When taking messages the PSR gathers
as much pertinent information as possible to help the MA/provider
turn around requests as quickly as possible. If patients call in
with urgent/possible emergent symptoms the PSR, utilizing
organization guidelines/protocol will determine if they need to be
triaged to a nurse, or referred to an Urgent Care or ER. The PSR's
on phones manage the providers schedule in order to ensure that
each appointment is allocated per appropriate network approved
slots. Demonstrated ability to successfully manage telephone
interactions Utilize appropriate tone, be pleasant and calm at all times Listen to information provided by the patient Document per template requirements, gather pertinent
information Successfully navigate through multiple software systems Complete calls on average within 1 minute and 45 seconds to 2
minutes Utilize first call resolve Appoints patient according to patient requests and/or schedule
limitations Appointment Making/Registration/Check-in and Payment
Processing A positive attitude, good listening skills, and patience are
essential when working the front check in desk successfully. Multi
tasking is a must in order to be successful at the front office
position. To check in patients efficiently, it takes someone who
can prioritize and make a decision quickly on what can be done now
and what can be done later. This ensures that the patients are not
waiting in line for longer than necessary and provider exam rooms
are kept full at all possible times. PSR's are responsible for
handling confidential patient information, so focus and attention
to detail are vital for this job. A PSR must verify the name and
date of birth with the physical patient on each interaction and
upon dispensing any and all documentation with patient related
information. As a representative of healthcare a pleasant smile, a
professional demeanor and good personal hygiene go a long way in
impressing the patients into continuing their health care with us.
Being attentive and responding quickly to the patient's needs and
questions makes them feel validated, and confident about their own
healthcare. An efficient PSR knows the importance of good
communication with the back office regarding appointments on the
day list to ensure a smooth transition for the MA's and providers
throughout the day. PSR's must ensure that insurances are loaded
correctly to make the billing process as smooth as possible. The
PSR is also responsible for accurately collecting and recording
copays/deposits. Correct billing instills confidence in the patient
and helps build a positive experience for them when they choose us
for their healthcare needs. Appointment Making: Prepares and maintains appointment timetables for all providers,
including physicians, physician assistants, nurse practitioners,
RNs, and other patient care services. Make appointments for outpatient services as requested. Cancels
and reschedules appointments as necessary. Arranges for specific patient needs for the time of the
appointment, including interpreters, wheelchairs, etc. Screens appointment calls for emergencies (911) and urgent
requests go to appropriate team member as necessary. Maintains and works lists for patients needing appointments when
patient management system is down. Give the patient the option of
leaving name and number, or calling back at a later time. Registration (Patient Management System): Verifies and updates the following information each time an
appointment is made: Address, city, state, zip Day and evening phone numbers Reviews the appointment screen for financial/clinical and other
flags and refers patient to patient financial services when
appropriate. Add new account and subscriber information as identified. Determine if visit is for an accident or injury, or other type
of billable service (i.e., private pay, third party). Reviews required fields in the business information management
system to assure that minimum data set information is current and
up to date at each patient visit. Registration - Check In: Checks patients in for their appointments. Verifies whether or not patient address, phone number,
employment, or insurance information has changed since the
appointment was made. Directs or assists patients in completing appropriate
paperwork. Generates labels and prepares chart for visit or service. Directs patient to location to wait or receive services,
including lab work or x-rays. Provides information and supplies as necessary. Responsible for the efficient processing of patients through new
patient and established patient registration. Payment Processing: Identifies and collects co-payments for all outpatient
services. Performs daily cash reconciliation and reporting. Receives and directs other payments coming into the
facility. Responds to questions/issues regarding patient billing. Collects appropriate paperwork for the visit. MEDICAL RECORDS: SCANNING/ELECTRONIC FAXING As a scanner you are responsible for ordering charts from
archives, managing the clinic worklist by sending charts out to
various clinics whom have requested them, scanning from charts for
patients that are coming in for appointments which consists of
documents designated per network guidelines. In addition the
scanner is also responsible for scanning the incoming mail and
managing incoming fax's. As needed the scanner is also asked to be
a back up phone person for overflow calls. The skills associated
with the scanner position are detail oriented, ability to
multitask, being able to prioritize what needs to be scanned and
assigned to providers first such as lab results, radiology exams,
and refill requests. You should also be comfortable in identifying
what an incoming document is such as consults, hospital records,
transfer records, labs, and pathology and to be able to
appropriately assign these documents under the correct section in
patient's electronic chart. It is also essential to have time
management skills to ensure that priority documents get assigned to
patients PCP when they arrive at the office. Name, date of birth and naming convention is verified to the
Electronic Medical Record prior to scanning. All information is filed in the correct section of the
Electronic Medical Record All incoming documents are analyzed based on priority. High
priority information is scanned first into the electronic medical
record daily. CHART PREP Chart prep responsibilities include prepping all scheduled
appointments for the next day and any add on's for same day
appointments. The chart prep person must look up each patient
appointment to ensure the patient has an active EMR chart, and if
not pull and prep the chart for the scanner to ensure the pick list
is scanned into the EMR chart before the provider appointment. As
part of chart prep the PSR makes sure each appointment is prepped
with labels, medication list, and any forms needed for the visit
(examples include CPE questionaire,PHQ-9, face sheet, VFC status
forms, etc.) Chart prep is also responsible for making sure all
charts in storage at iron mountain are requested by the scanner to
ensure the provider has the 2007 or older chart available to review
at the appointment and that the pick list is scanned prior to
visit. Chart prep also serves as back up for the front desk during
lunches and during peak phone hours to help keep our abandonment
rates low and decrease patient wait times. Chart prep requires the
PSR to multi-task and be aware of the clinic flow at all times to
help assist in any area within the clinic that may need coverage,
be detail oriented and efficient to facilitate all appointments are
properly prepped for each appointment. This helps to ensure the
provider and MA has everything required to spend as much time with
each patient and make sure their needs are met. Ensures all patient appointments are prepped in a timely and
accurate manner. Maintains attentiveness to continuous updates and "add-on's" to
the Day List. FACILITATOR/BACK OFFICE DUTIES It's essential to maintain a calm demeanor to manage multiple
tasks while in the back office as a PSR facilitator. Messages from
patients, orders from providers, and faxes are coming in throughout
the day at a fast rate so it is imperative to be checking each
system to ensure a smooth process. As a PSR in the back, your job
is to multitask, prioritize, organize and facilitate workflow for
the provider and MA. Having this skill set will aid in
accomplishing smooth team nursing for the MA's. A well rounded PSR
should be able to instill confidence in the provider by following
through on their requests and continuing an exceptional patient
care experience. The following are some of the main duties of a
facilitator: participate in huddles with providers and MA's to
anticipate needs/orders/procedures for the day, view daily schedule
throughout the day to track when patients arrive in order to
communicate/assign to an MA as needed, read, investigate and
forward messages to appropriate provider (if needed), contact
patient when messages have been answered and record message in
Electronic Medical Record, call pharmacies to call in prescriptions
that have been approved in Electronic Medical Record or refax
through rightfax, facilitate care management calls if necessary,
expedite written orders from provider (no verbal orders of any
kind), fax or mail paperwork to pharmacies, other medical centers
and patients and ensure all paperwork is signed off by appropriate
provider in a timely manner. Manages messaging and order workflow. Organizes and allocates orders in a timely fashion Researches and responds to messages in a timely fashion. REFERRALS As the referral PSR you are sent physician orders in electronic
medical record for patients that are being referred out to either a
specialist or to have a procedure (i.e. MRI, CT Scan). The PSR is
then required to verify if that patient's insurance plan requires a
referral or prior authorization and if so the PSR will contact the
insurance company either online or by telephone to request the
referral/prior auth. Once the PSR determines if a prior
authorization is required or not then you update the referral/order
in electronic medical record. If no referral/prior auth is required
then you can update the order with that information, your name, and
then complete the order in electronic medical record. If a
referral/prior auth is required then you request that from the
insurance company and then update the order with the auth#,
effective dates and your name. If the request has to be reviewed by
the insurance company then you may be required to provide clinicals
(chart notes, labs, diagnostic testing results, CPT/DX codes) along
with your request and fax the information to the appropriate fax
for that insurance company. If this process is required then the
order is changed to sent status in electronic medical record until
the approval or denial is received from the insurance company. The
PSR will have to hold the paper fax request in the pending file
folder until a decision is made and follow up with the insurance
company until they reach a decision then update the order in
electronic medical record. When a referral/prior auth is received
the order in electronic medical record is updated with the Auth#,
effective dates, your name and then the order is completed. Facilitates communication between the clinic and insurance
company. Manages the tracking of referrals requiring pre-authorization
and all Diagnostic Imaging. Follows up with patients who completed orders. Facilitates
communication between patient and provider on incomplete
orders. Other: Responds to patients' questions and investigates and
communicates answers as appropriate. Receives, distributes, and responds to mail for work area. Monitor office supplies and equipment, keeping person
responsible for ordering updated. Float Pool Addendum: Able and willing to travel from one clinic to another within the
VMC network on a regular basis, including same day travel. Job Qualifications: Prerequisites: High School Graduate or equivalent (G.E.D.) preferred. Demonstrates basic skills in keyboarding (35 wpm) and using a
personal computer in Windows 2000 or XP environment. Able to communicate effectively in oral and written form in
English language. Evidence of excellent communication skills both oral and written
including the ability to spell accurately and write legibly. Excellent customer service skills. Knowledge of medical terminology and abbreviations and can spell
and understand commonly used terms preferred. Float Pool: General Qualifications: Demonstrated ability to function effectively and interact
positively with patients, peers and providers at all times. Demonstrated ability to access, analyze and apply concepts
associated with protocol, policy and guidelines. Demonstrated understanding of agency compliance standards. Possess excellent customer service skills: the reception area. Ability to communicate and work effectively with the physical
and emotional development of all age groups. Neat and well-groomed appearance, business professional. Demonstrated ability to maintain a calm demeanor at all
times. Demonstrated ability to function effectively in an environment
where it is necessary to perform several tasks simultaneously, and
where interruptions are frequent. Demonstrated ability to successfully manage telephone
interactions. Demonstrated ability to speak, spell and utilize appropriate
grammar and sentence structure. a. Utilize multiple monitors in facilitation of workflow
management b. Scanning and electronic faxing capabilities c. Electronic Medical Records d. Business practice management system e. Preparation and printing of fee slips f. Preparation of patient chart
Keywords: Valley Medical Center, Renton , Patient Service Rep, Other , Renton, Washington
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