Patient Care Representative

Summary: This position supports the Organization in the following manner:

• Greet patients, visitors, and others upon entry and, if required, process the account upon their exit
• Set appointment times and call patients to confirm appointments
• Support the clinical staff with an available patient chart/record
• Gather and evaluate confidential patient information, including insurance or financial data for the purpose of determining patient responsibility and/or qualification for financial assistance
• Accurately maintain the patient database software system
• Serve as a recipient for packages, etc. (with limitation)
• Serve as a payment collection resource, including a reconciliation at the end of the business day

Reports to: COO

Supervises: N/A

Dress Requirement: Scrubs

Work Schedule:

Monday through Friday during HOFH’s standard business hours

Times are subject to change due to business necessity

Non-Exempt

Job Duties, these are considered essential to the successful performance of this position:

• Pull the patient’s record or prepare a new record / chart in preparation of the clinical visit
• Optimistically greet persons upon entry and assist them upon exit, striving to meet and exceed the expectations of patients, visitors and other staff members
• Notify the appropriate staff member of their appointment’s arrival
• Gather and evaluate confidential patient information, as related to insurance or financial data for the purpose of determining patient responsibility and/or qualification for financial assistance
• Perform verification on insurance data and/or benefit enrollment that is submitted by the patient
• Accurately maintain the patient data base software system by ensuring all data entered is true and correct
• Answer the phone in a timely and efficient manner, identifying the Organization and optimistically greeting the caller
• Transfer all phone calls to the appropriate staff member
• Set appointment times in coordination with the medical staff work schedule and call patients to confirm appointments
• Accept deliveries - except those required to have a personal signature from an employee; notify the employee or the Director of Human Resources or Director of Quality and Compliance
• Collect payment and co-payment for medical services rendered
• Accurately perform daily closing procedure
• Consistently ensure HIPAA regulations and other federal, state and local laws and regulations pertaining to the duties of this position are observed
• Adhere to all of the Organization’s policies and procedures, especially the hazardous, health and safety procedures
• Other duties as assigned (non-essential)

Facility Environment:

All facilities have a medical office environment with front-desk reception area, separate patient examination rooms, nursing stations, pharmacy stock room, business offices, hallways and private toilet facilities. All facilities are on the main ground floor and ADA compliant

This position’s primary work area is the reception desk area which is shared by other co-workers with similar tasks and functions. The reception desk area is:

• kept at a normal working temperature
• sanitized daily
• maintains standard office environment furniture with adjustable chairs
• maintains standard office equipment; i.e., computer, copier, fax machine, etc. at a normal working height

Equipment Operated:

Physical Demands and Requirements: these may be modified to accurately perform the essential functions of the position:

• Mobility = ability to easily move without assistance
• Bending = occasional bending from the waist and knees o Reaching = occasional reaching no higher than normal arm stretch
• Lifting/Carry = ability to lift and carry a normal stack of documents and/or files
• Pushing/Pulling = ability to push or pull a normal office environment
• Dexterity = ability to handle and/or grasp, use a keyboard, calculator, and other office equipment accurately and quickly
• Hearing = ability to accurately hear and react to the normal tone of a person’s voice
• Visual = ability to safely and accurately see and react to factors and objects in a normal setting
• Speaking = ability to pronounce words clearly to be understood by another individual

Job Qualifications (Experience, Knowledge, Skills and Abilities)

• Prefer experience with Allscripts software system
• Prefer experience with ICD-10 CPT code or other medical codes
• Prefer experience in a physician’s office, clinic, hospital business office, billing office or related area dealing with the public in collection of data and funds
• Understanding of laws and regulations impacting the registration procedure
• Prefer an understanding of third party payer benefits and the requirements and methods for reimbursement
• Ability to accurately enter data, preferably typing at a minimum of 45 wpm
• Ability to accurately input the ICD-10 CPT code and/or other information as dictated by the physician or nurse practitioner while understanding the relationship of diagnosis and procedural codes so errors can be corrected prior to a rejection of the billing
• Has the ability to diffuse and handle difficult situations by using good judgment, control of emotion and diplomacy
• Demonstrates grammatically-correct verbal and written communication skills
• Demonstrates efficient and courteous telephone skills
• Demonstrates resilience, a positive attitude and the ability to work well in a fast paced, rapidly changing environment
• Ability to work in a team setting and/or with minimal supervision