Patient Services Representative II

Job Summary

As a Patient Services Representative II, you play a crucial role in providing exceptional customer service and support to our patients, the public, and external healthcare facilities.  The primary responsibility will be to handle incoming calls, answer inquiries and assist callers with various healthcare related matters.  This position requires excellent communication skills, empathy, and the ability to multitask effectively in a fast-paced environment.

Essential Duties and Responsibilities

• Handle inbound calls while providing accurate and timely assistance.
• Serves as the first point of contact for inquiries related to appointments, health questions or concerns, and all other general information about Valley Health Care, Inc. services.
• Listen attentively to callers, identify their needs, and provide appropriate solutions or escalate complex issues to the relevant department or supervisor.
• Maintain a professional and empathetic demeanor while demonstrating patience, compassion, and understanding towards patients.
• Utilize computer systems and electronic medical records (EMR) to access patient records, update information, and document call details accurately.
• Follow established call center protocols and standard operating procedures to ensure compliance with company policies, industry regulations, and patient confidentiality guidelines, such as HIPAA.
• Collaborate with team members and cross-functional departments to resolve patient inquiries and provide seamless care.
• Continuously enhance knowledge of VHC services, procedures, payment options, and relevant regulations to provide accurate and up-to-date information to patients.
• Participate in training sessions, team meetings, and performance evaluations as required.
• Uphold the Code of Ethics and mission of VHC by conducting professional activities with honesty, integrity, respect, fairness, and good faith in a way that reflects well on the organization.
• Attend staff meetings when required.
• Other duties as assigned.

Education and Experience

• To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• High school diploma or equivalent.  Some college education or experience in healthcare, customer service, or a related field is preferred.

Minimum Qualifications

• Excellent verbal and written communication skills with the ability to convey complex information clearly and concisely.
• Empathetic and patient approach, with the ability to remain calm and composed during challenging interactions.
• Strong multitasking abilities to handle multiple calls, navigate computer systems and document information simultaneously.
• Familiarity with electronic medical records (EMR) or similar software systems is preferred.
• Understanding medical terminology, healthcare procedures, and insurance concepts is beneficial.
• Adherence to ethical guidelines and a commitment to maintaining patient confidentiality.
• Proficient computer skills and the ability to learn new software applications quickly.
• Ability to work flexible hours based on the needs of patient services operations.
• Must be able to interpret medical and work environment-related documents involving patient care, program descriptions, government regulations, and VHC policy and procedures.

Professional Standards

• Leadership 
  • Team building mentality is exemplified in all work done. 
  • Positively influence and uplift members and other affiliates. 
• Employee Expectations 
  • Follow all policies and procedures, including the Code of Conduct, which can be found in the Employee Handbook. 
  • Follow the direction given by the supervisor to ensure site expectations are met. 
• Communication 
  • Must be able to provide important and relevant site information in staff meetings and to members, co-workers, and supervisors. 
  • Must be able to listen to co-workers and team members. 
  • Must be able to present important and relevant site information to supervisors. 
  • Must be able to write and compose clear, concise, accurate written documentation and data reports, as necessary. 

Values

Upholds the Code of Ethics and mission of Valley Health Care, Inc. by conducting professional activities with Valley Health Care’s values of integrity, teamwork, compassion, excellence, and Here for Good.

     Integrity

          We act openly and truthfully in everything we do.

     Teamwork

          We work together to serve our patients.

     Excellence

We create better ways of doing the things we do and provide the highest quality of care for each patient every time.

     Compassion

         We treat each other and our patients with concern, kindness, and respect.

     Here for Good      

          We make decisions that will best serve our patients now and in the future.

Understanding of Health Care Laws and Regulations

Must have the ability to follow HIPAA guidelines as well as an understanding of policies and procedures regarding medical records put in place by the Federal Government, Medicaid, Medicare, and WV Behavioral Health Laws put forth by the WV Department of Health and Human Resources. 

Customer Service

Must listen to the customer, understand the customer, do what needs to be done to meet the customer’s expectations, and take ownership for the customer experience.

Computer Literacy

Knowledge of basic computer software (MS Office – Word, Excel, and Outlook) and the willingness and ability to learn electronic medical records software. 

Reasoning Ability

Must demonstrate the ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret various instructions furnished in written, oral, diagram, or schedule form.

Teamwork

An essential element is the ability to work and interact effectively and positively with other staff members to build and enhance teamwork in the VHC organization; team engagement is necessary to be successful in this position. 

Work Record

A demonstrated work record showing good attendance, punctuality, dependability, and the ability to collaborate well with supervisors and coworkers as part of a team effort is essential. A medical office setting is an environment that requires the ability to relate to all types of people while always maintaining a professional demeanor. 

Language Skills

The ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals is essential. The ability to write routine reports and correspondence, and the ability to speak effectively to patients, co-workers and the public at large is crucial. 

Additional Skills

Must be able to read and interpret medical and work environment related documents involving patient care, program descriptions, government regulations and VHC policy and procedures. 

Sensitivity to Needs of Special Populations

Must be able to demonstrate an understanding and sensitivity to cultural differences and needs of VHC patients and be able to respond appropriately to all people regardless of race, ethnicity, language, age, sex or sexual orientation, religion, disability, economic standing, etc. 

Physical Demands

The physical demands described here represent those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee may be required to drive, sit and stand for extended periods of time; handle papers, type and operate computer equipment; reach with hands and arms; talk in-person, on the telephone, and by electronic means; see and hear, and lift up to twenty-five pounds. 

Work Environment

Work is performed in a typical outpatient clinic environment and at locations outside the office. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions of the job.