Patient Service Specialist

Northern California Retina Vitreous Associates Medical Group, Inc is seeking a dedicated and compassionate Patient Service Specialist to join our retinal practice. The ideal candidate will possess excellent communication skills, a strong understanding of medical administrative procedures, and a commitment to delivering outstanding patient care. In this role, you will serve as the primary point of contact for patients, ensuring smooth appointment scheduling, accurate documentation, and efficient handling of medical records. Your expertise in electronic record (EHR/EMR) systems and insurances will be essential to support seamless clinic operations and enhance patient satisfaction. This position offers an engaging opportunity to contribute to a high-quality healthcare environment while utilizing your comprehensive administrative and clinical knowledge. This position is on-site near the Good Samaritan Hospital in West San Jose. The hours are Monday to Friday from 8:00am to 5:00pm with a 1-hour lunch.

List of Responsibilities/Duties:

• Receive and handle incoming phone calls for all locations
• Confirm caller’s information (i.e. location and usual provider if a patient is calling)
• Answer questions, address issues, and ensure all appropriate actions are taken for each phone call
• Educate callers regarding practice systems (i.e. phone, referral, etc) and any other processes as necessary
• Help route calls to appropriate internal department or contact when applicable
• Ensure calls are documented in a thorough and complete manner in the appropriate location (i.e. patient’s chart when regarding patient or via email when non-patient related)
• Triage patients calling to schedule appointments or referrals from referring providers
• Ensure appointments are scheduled optimally based on diagnosis, provider availability, preferred locations, patient’s insurance, etc.
• Contact Referring providers for additional information as needed.
• Address open action items with patient while they are on the phone whenever possible such as outstanding balance collection, collecting pertinent information, verifying insurance when ineligible, etc.
• Verify and load insurance accurately for new patients per new patient referral process.
• Verify insurance for established patients when scheduling or confirming upcoming appointments.
• Check auth requirements and if required, ensure it’s on file or alert Authorization Specialist if not on file.
• Review chart for pending items, errors, or any other issues when assisting a patient calling in.
• Advise all impacted teams of any significant changes or issues with patient’s coverage.
• Collaborate with the RCM team to resolve any issues or concerns surrounding insurance coverage, authorizations, patient balances and/or credits.
• Help maintain referral provider directory. Mail out referral forms to referring providers as requested.
• Assist with addressing messages from call service and escalate issues as necessary.
• Assist with addressing issues or concerns regarding referral methods/platforms.
• Provide outstanding customer service and maintain positive working relationships.
• Communicate effectively; Respond to correspondence such as emails, Pt Tasks, etc, in a timely manner.
• Follow written and verbal directives from management.
• Help cover the front office as a Front Office Specialist when needed.
• Assists with other patient service responsibilities as requested.

Duties and responsibilities may be added, deleted, or changed at any time at management's discretion, formally or informally, either verbally or in writing.

Minimum Education Requirements:

• High school diploma or GED.
• Good verbal and written communication skills.

Minimum Background Requirements:

• Knowledge of basic computer skills such as Microsoft Office Suite (Outlook, Word, Excel, SharePoint, etc)
• Demonstrated knowledge of insurance and benefits requirements

Minimum Demonstrated Skills:

• Fluency in Vietnamese is a plus!
• Performs daily activities of auditing of patient accounts to ensure accuracy
• Cheerfully answers patient inquiries in person and on the phone.
• Assists callers willingly, professionally, and accurately.
• Always maintain patient confidentiality and communicate with the compliance officer regarding procedural changes and concerns.
• Cooperates and communicates with all staff members and physicians.
• Attends required meetings.
• Participates in professional development efforts to stay current on insurance coverage changes and regulatory matters.
• Demonstrates a willingness to help as needed in all patient service roles.
• Complies with all other company policies and procedures including punctuality, attendance, dress codes, and health and safety policies and procedures.
• Word processing and computer experience required.

Physical Demands:

• Regularly required to use hands to type, handle or feel.
• Ability to sit for long periods of time, with occasional bending.
• Must on occasion lift and/or move up to 20 pounds.
• Must be able to view and enter data into the computer for extended periods.
• Must be able to communicate via the telephone.

Pay: $26.00 - $29.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid sick time
• Paid time off
• Vision insurance

Language:

• Vietnamese (Preferred)

Ability to Commute:

• San Jose, CA 95124 (Preferred)

Work Location: In person

Salary : $26 - $29