Patient Service Representative

Job Title: Patient Service Representative

Department: Patient Service Center

Reports To: Manager of Patient Services

FLSA Status: Non-Exempt

Lowell Community Health Center (Lowell CHC) is a community-based health care organization. Our programs have been recognized as national models. With a career at Lowell Community Health Center, you will be joining a dynamic team of passionate and talented people.

Summary:

The Patient Service Representative at Lowell Community Health Center is a crucial member of the healthcare team and the first point of contact for patients, visitors, and staff. This role is responsible for delivering excellent customer service, managing patient intake and registration, verifying insurance, scheduling appointments, performing collections, and supporting administrative operations in a fast-paced environment.

Responsibilities:

Patient Reception:

·        Serve as the primary point of contact for patients, addressing inquiries and ensuring effective communication between patients and healthcare providers.

·        Greet patients and visitors with a warm and friendly demeanor.

·        Check in patients for appointments and verify personal and demographic information.

·        Direct patients to appropriate waiting areas or examination rooms.

Registration Data Collection:

·        Accurately gather and input patient demographic, insurance, medical, and financial information into the practice management system.

·        Document patient consent and ensure compliance with regulatory requirements.

Insurance Verification & Prior Authorization:

·        Enter and update insurance information in the practice management system in a timely and accurate manner.

·        Verify patient insurance eligibility and coverage using multiple systems.

·        Confirm prior authorizations and primary care provider (PCP) assignments; assist in resolving access issues.

·        Verify effective dates and benefit details including co-pays, PCP site, and outstanding balances.

·        Work closely with Health Benefits Navigators to resolve issues for uninsured or underinsured patients.

·        Address eligibility alerts, electronic actions, and telephone encounters to correct patient accounts.

·        Contact patients with inactive insurance to obtain updated information in advance of appointments.

Appointment Scheduling:

·        Ensure accurate data entry in the electronic health record (EHR) system.

·        Schedule, reschedule, or cancel patient appointments as needed.

·        Provide patients with appointment details and preparation instructions.

Collection Duties:

·        Inform patients of co-pays, outstanding balances, and other financial responsibilities.

·        Collect payments and provide receipts as required.

·        Educate patients on payment options including cash, check, credit card, and online payments (e.g., MyChart).

·        Provide information on insurance coverage and financial assistance programs, including sliding fee scale options.

·        Refer patients to Health Benefits Navigators when appropriate.

·        Promote and assist patients with Patient Portal enrollment and respond to portal requests per protocol.

Communication and Customer Service:

·        Deliver exceptional customer service and maintain a welcoming environment.

·        Use effective questioning and listening skills to support telephone and in-person communication.

·        Resolve patient complaints and concerns professionally and in a timely manner.

·        Maintain patient confidentiality and respect patient dignity at all times in compliance with HIPAA.

·        Communicate effectively with care teams to ensure smooth patient flow.

Administrative Duties:

·        Maintain and update patient records in the electronic health record (EHR) system.

·        Manage patient intake forms, insurance documentation, eligibility checks, and prior authorizations.

Office Organization:

·        Maintain a clean, organized, and professional front desk environment.

·        Monitor office supplies and request restocking as needed.

Collaboration and Teamwork:

·        Work efficiently both independently and as part of a team.

·        Collaborate with providers, nurses, and medical assistants to support patient care.

·        Assist in coordinating referrals to specialists or other departments.

·        Participate in departmental meetings and trainings as required.

Qualifications:

·        High school diploma or equivalent; additional education in healthcare administration or related field preferred.

·        Experience in a healthcare or customer service environment preferred.

·        Strong communication and interpersonal skills.

·        Proficiency in Microsoft Office and EHR systems.

·        Ability to multitask and work effectively under pressure.

·        Knowledge of HIPAA and healthcare regulations preferred.

·        Bilingual language skills highly preferred.

Work Environment:

Frequent contact with patients, families, visitors, nurses, and other staff. Occasional need to change work areas to meet patient needs. Exposure to multiple simultaneous demands and moderate stress levels. Possible exposure to infectious diseases; adherence to universal precautions and use of protective equipment is required and supported.