Medical Administrative Assistant

POSITION SUMMARY:

The Patient Services Representative has successfully completed the Ophthalmology Home Study course and the LMS Customer Service program and has passed the EANM Insurance Test.  (If the employee was grandfathered into this job in July 2015, he/she is expected to complete all of the fore-mentioned within 1-2 years of that grandfathering date.) Cross-trained to perform both check-in and check-out functions utilizing to the fullest capability the NextGen and Phreesia platforms. Accurately schedules patients and enters all new patient information into the computer.  Updates established patient information into the computer. Accurately and efficiently performs all checking out processes for all patients.  Provides support assistance to support staff and to EANM physicians. Is responsible for cash drawer protocols.  May function as a knowledgeable resource for all insurance plans in compliance with EANM guidelines.  Completes miscellaneous billing and coding functions as assigned. As PSR's are essential workers, they are required on-site in clinic to work during epidemics, pandemics, and inclement weather.

ESSENTIAL FUNCTIONS/RESPONSIBILITIES:

• Accepts responsibility for timely arrival and readiness for work at assigned station, appearing well-groomed, professional and friendly.
• Exhibits a friendly, professional customer service style in all patient interactions (in person and via the telephone) to create a positive service experience.
• Learn extensive insurance knowledge, have computers skills, and adaptability with changes in software programs and platforms.
• Must be able to multi-task, problem seek and solve, and communicate effectively with internal and external customers.
• Answers and screens incoming calls in a professional and timely manner, assists the patient or forwards the call to the appropriate department.
• Schedules patient appointments in a timely manner, striving to set appointment times, dates and locations for the convenience of the patient. Scheduling with the correct provider or specialty.  Responsible for entering patient Recall data for returning patients, as well as complying with all Meaningful Use and MIPS procedures.
• Assists patients in scheduling appointments with other providers participating in the patient’s care.
• Reschedules patients in a timely manner due to physician schedule changes, exhausting all efforts to contact patient.
• Assists both new and established patients with the registration process using both the NextGen and Phreesia platforms either in person or via the telephone/text.  This includes verifying H&P and HIPAA signatures are on file; entering patient demographic and insurance information, ensuring that the appropriate referrals and prior authorizations have been obtained, verifying the co-pay, scanning legible pictures of patients and insurance cards into the patient's profile in EMR. 
• Update both the Phreesia and NextGen platforms with patient demographic and insurance updates.
• Ensures that patient is eligible for insurance by running insurance eligibility via Phreesia, IPAS, and insurance-based web-sites.
• Communicates with patient billing/insurance inquiries, providing patient with an estimate of their out of pocket fees for the exam.
• Assists patients with immediate and future referral and insurance authorization needs, including in-office procedures, to include Punctal Plugs and YAGS.
• Schedule outside testing and obtain prior authorizations, to include MRI's and ERG's.
• Coordinates with clinical staff regarding physician schedules and timeliness, and communicates delays to patients as needed.
• Checks patient out after doctor’s exam, communicating with the patient balance due at the time of service, collecting patient balance at the time of service and/or documenting on patient encounter patient balances not collected. 
• Ensures the accuracy of the encounter insurance at check-out, to correspond with the diagnosis and coding, making changes as necessary.
• Follows batching procedures through Phreesia to balance daily patient balance collection.
• Controls assigned cash drawer, verifying amount every morning and evening.
• Performs chat function through Phreesia to increase communication to patients to help with balance collections, no-show ratios and other clinic initiatives.
• Remains helpful to patient at all times (escorts patient to designated area, offers assistance if needed, and calls for transportation for patients as requested).
• Creates Patient Communication in a timely manner for those calls that must be returned by the physician/technician, and tasks them appropriately.
• Assists doctors with management of calls and appointments; keeps doctor/technician advised on patient flow compared to the schedule; helps with sorting and distribution of the mail
• Opens and/or closes the office as assigned.  
• Work in a rotation to provide coverage for Saturday and Holiday clinics.  
• Performs cleaning during the clinic day to sterilize patient contact areas/items, following EANM cleaning protocols set forth by EANM.
• Maintain assigned provider's schedule, ensuring that they are not under booked, overbooked, and looking ahead to maximize upcoming schedules for providers to maintain clinic patient volume and initiatives.
• Process incoming electronic referrals from outside providers and documenting in patient's chart referral outcome.
• Work task inbox, accepting, charting and completing internal tasks daily as assigned, to include coordinating appointments for patients with EANM specialists within the appropriate timeframe. 
• Cross-train to work at multiple locations, with a knowledge of all specialties and physicians.
• May be asked to assume the following additional responsibilities:
  1. Facilitate contact lens ordering and collection of payment
  2. Receipt and distribution of outer office correspondence
  3. Scanning and indexing of patient records
  4. Inventory control and supply ordering
  5. Daily balancing and daily bank deposits
  6. Perform PODIS processes in injection clinics to maintain EHR documentation and inventory controls
  7. Schedule and obtain Prior Authorization for bloodwork and Genetic Testing.
  8. Schedule and send links to patients that are going to be seen via Telehealth.
• The annual completion of assigned Learning Management System (LMS) courses is mandatory.  Any individual who has not completed their assigned training prior to November 30th of each year may be subject to disciplinary action, up to and including termination of employment.

SKILLS/QUALIFICATIONS:

Job requires high school education or equivalent.  Experience in Microsoft Office is preferred; other computer experience is desirable.  Experience and/or training in bookkeeping is preferred. Medical terminology and medical office experience preferred. Must demonstrate the ability to interact with the public in a pleasant, helpful and professional manner.  Must work well as a member of a team.  Must have passed the Ophthalmology Home Study course and the LMS Customer Service program, and must have passed the EANM Insurance Test.  (If grandfathered into this position in July 2015, employee must complete the aforementioned within 1-2 years of having been grandfathered.)

Req.# 2762