Lead Patient Services Representative - Pediat

This document is intended to describe the general duties required for this position.  It is not intended to serve as an exhaustive list of all duties, responsibilities or physical requirements. Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position.

Position Summary

The Lead Patient Services Representative (PSR), Pediatrics, reports directly to the Director of Patient Services and works closely with the Chief of Pediatrics in supporting the efficient operation of the Pediatrics department. This role provides frontline leadership and coordination for the Patient Services team, ensuring daily operations run smoothly, staffing is managed effectively, and patient access and experience are prioritized.

The Lead PSR, Pediatrics will assist with staff assignments, oversee day-to-day PSR activities of the Pediatrics department, coordinate scheduling and time-off requests, and support process improvements that enhance workflow and service delivery. This position requires the ability to assess PSR staffing needs and ensure adequate coverage during all hours of operation, while maintaining appropriate staff levels and productivity. They also play a critical role in organizing staff workload, setting and reinforcing work standards, and fostering a patient-centered, team-oriented environment.

Essential Duties and Responsibilities

Oversight & Leadership

• Provides guidance and assists with Pediatrics specific training and problem-solving; monitors staff performance in accordance with organizational policies and procedures.
• Conducts regular check-ins at all assigned sites.
• Attends weekly meetings with the Chief of Pediatrics and the Director of Patient Services to address inefficiencies, present PSR updates, and provide ideas to improve efficiency, productivity, and patient satisfaction.

Training & Staff Development

• Provides guidance and Pediatrics specific training on:
• Use of the electronic health record (EHR) to document patient registration, pre-certification, check-in, check-out, charge capture, and follow-ups.
• Developing an understanding of Pediatrics knowledge, including procedures, timelines, pre-authorizations, and Pediatrics registration forms.
• Delivering excellent customer service, including greeting patients and visitors in a prompt and courteous manner and promptly answering questions.

Staff Management

• Conducts schedule reviews a minimum of two weeks in advance to maintain the optimum number of patient encounters each week.
• Ensures that prior to each appointment, PSRs inform patients of their financial responsibilities (co-pays, deductibles, etc.) and insurance benefits.
• Ensures all required Pediatrics pre-authorizations are completed and received prior to scheduling appointments.
• Ensures that PSRs successfully complete the following:
  1. Verifying and entering patient information into the EHR.
  2. Collecting and processing patient insurance information.
• Notifies the Pediatrics PFC of any gaps in coverage for scheduled patients.
• Manages any Pediatrics specific patient refund requests with the Chief of Pediatrics.
• Reviews the scanning of all patient documents, monitoring for accuracy and productivity.
• Reviews the daily closeout tasks of all assigned sites and ensures all payments and balances are posted.

Administrative & Other Duties

• Assists with preparing and presenting departmental policies and procedures.
• Performs other related duties as assigned by management.

Supervisory Duties and Responsibilities

• Directly leads a specified Pediatrics team within the Patient Services department.
• Responsibilities include interviewing, hiring and training employees; planning, assigning, and reviewing PSR work; appraising performance; disciplining employees; addressing complaints and resolving problems. 

Qualifications

• High School Diploma or equivalent required, Associate’s degree in Health or Business Administration, preferred.
• A minimum of three years’ medical office Pediatrics experience in an outpatient setting required 
• Demonstrated proficiency in Microsoft Office Suite applications and electronic medical record (EMR) systems is required.
• Exceptional customer service skills and the ability to communicate effectively, both verbally and in writing, to provide clear guidance to staff.