Community Inclusion - Patient Services Representative - Dayforce : Job Details

The Resource Center has been providing services to persons with disabilities in the Chautauqua County area since 1958. From our humble beginnings as a gathering of parents and concerned citizens who wanted to provide educational and training opportunities for persons with developmental and intellectual disabilities, The Resource Center has grown into a comprehensive agency providing services to thousands of persons with all types and levels of disabilities.The Resource Center is the largest non-governmental employer in Chautauqua County with more than 1,300 employees on its payroll.The mission of The Resource Center is to support individuals with disabilities and other challenges in achieving maximum independence, contributing to their community, experiencing lifelong growth, and enjoying quality of life.TITLE: PATIENT SERVICES REPRESENTATIVE RESPONSIBLE TO: Site Manager FUNCTION: Welcomes patients in a positive customer-focused manner. Perform a wide variety of activities designed to facilitate and maintain the smooth, efficient flow of operations within a variety of integrated care. Ensure timely and accurate collection of all required information including but not limited to patient's demographics and insurance details. Ensure information is up to date and accurate at each visit in order to obtain maximum reimbursement. Maintain confidentiality and accurate and up to date healthcare information is recorded in the Electronic Health Record (EHR) system in a timely manner in order to provide the most complete and accurate patient record possible and to facilitate optimum patient care.SPECIFIC DUTIES:

Greet and assist patients, visitors in a prompt, courteous and helpful manner.

Answer telephone, take messages and provide information on services.

Optimize patients' satisfaction, provider time, and treatment room utilization when scheduling appointments in person and/or by telephone which meet the defined guidelines.

• Ensure efficient and timely patient experience by:
• keep patient appointments on schedule
• notify provider of patient's arrival
• review service delivery compared to schedule and notifying provider and/or management of discrepancies
• notify provider and/or management of service delays

Ensure patients' comfort by promptly addressing any questions, concerns and anxieties.

Maintain a welcoming, sanitized and comfortable reception area.

Protect patients' rights by maintaining confidentiality of personal and financial information, and comply with State, Federal and Practice guidelines.

Investigate and resolves issues with accounts in a timely manner.

Assist patients in distress by promptly and effectively responding to emergencies.

Effectively utilize designated EHR systems for the collection, compilation and entry of information to ensure complete, accurate and up-to-date medical records.

Responsible for:

• Triage of incoming calls, assigning to appropriate personnel as needed
• medical and insurance referral records
• insurance verification & resolution
• protocols and tracking, including maintenance of records, daily schedule summary
• resolving patient referral issues as assigned
• securing prior authorizations as assigned

At the time of each visit:

• verifies patient account information, including but not limited to demographic and insurance information, capturing patient photo for medical record, patient contact, payer contact, registration interfaces and automated processes.
• Collects payments due from patients upon arrival to clinic, including but not limited to Medicaid co-pays, prior payment agreement contracts, insurance co-pays, and outstanding bills. Keeps daily record of transactions and maintains a balanced cash drawer.

In order to facilitate the receipt of all reimbursement due, works with the Manager to:

• investigate and correct errors
• research missing or incorrect account information
• identify issues/trends with payers
• appropriately update account activity

Resolve registration and claim edits and completes registration reports to facilitate processing of charge entry and claim submissions.

Refer patients to appropriate personnel for billing concerns and questions, navigation and care coordination

Perform assigned clerical duties including typing, filing, and record keeping.

Ensure work areas are maintained in a neat and orderly manner, this includes waiting room

Report any ideas and suggestions regarding processes, procedures and protocols to management in order to facilitate the smooth and efficient operation of assigned service environment(s).

Provide excellent customer service

Performs all other duties as needed or assigned.

As assigned, may be responsible for Medical Records:

• Assist in responding to requests for Release of Information, including location and distribution of needed documents, in a timely manner and consistent with HIPAA guidelines.
• Ensure timely and accurate entry and/or filing of paperwork and electronic transfers of information received from outside sources into the patient record, consistent with HIPAA guidelines.
• Preparing patient charts and gathering information and documents from patients
• Ensuring that the medical records are organized, accurate and complete
• Creating digital copies of paperwork and storing the records electronically
• Filing the paperwork and reports of patients quickly and accurately
• Safeguarding patient records and ensuring that everyone complies with the HIPAA standards
• Transferring data into the facility's main system database, sending to providers as needed for follow-up/completion.
• Processing the records for admitting and discharging patients
• Preparing invoices

REQUIRED KNOWLEDGE, SKILLS AND ABILITIES:Exemplary customer service skills, including the ability to effectively deal with a variety of individuals including patients, providers and other customers in a calm and professional manner; excellent telephone and verbal communication skills, as well as, effective interpersonal skills which promote cooperation and teamwork; Demonstrated ability to effectively utilize multiple Electronic Health Record Systems, in addition to computer software programs such as Microsoft Word. Comprehensive knowledge of information gathering, processing and filing systems; working knowledge of medical records management and office administration protocols, as well as, working knowledge of basic accounting and billing principles; flexibility, reliability and ability to self-direct and self-initiate in order to meet deadlines. Must be detail-oriented and possess strong organizational and time management skills, including the ability to effectively manage multiple priorities in a competent manner. Typing ability sufficient to perform data entry. Physical condition or reasonable accommodation(s) commensurate with the demands of the job. Technical Skills:• Strong data entry skills• Excellent verbal and written communication skills• Advanced organization skills • Attention to detail to ensure accuracy• Familiarity with medical terminology• Basic computer skills to scan, organize and access electronic health records• Good time management skills• Excellent problem-solving skillsMINIMUM QUALIFICATIONS:Associate's Degree in business, accounting, medical office or related field plus one (1) year of demonstrated office experience. Experience in medical office or medical billing strongly preferred; OR three (3) years of demonstrated office experience. Experience in medical office, registration, medical billing, and/or Medical Records Certificate strongly preferred. Candidates who are bilingual in English and Spanish preferred. Required Tools:

Badge Access

Designated E.HR system(s)

E-mail (internal and external account)

Internet (with research browsing capabilities)

Shared Drives

Insurance portals, as designated

Others as needed or requested

The Resource Center is an equal employment opportunity employer and will not discriminate on the basis of race, color, creed, religion, sex, sexual orientation, gender identity, national origin, age, marital status, citizenship status, military status, domestic violence status, predisposing genetic characteristics or genetic information, physical or mental disability, any other category protected by law, or any other non-job related characteristic. As needed, The Resource Center will provide reasonable accommodations for disabilities to employees and applicants whenever such accommodation would not create an undue hardship or a safety concern in the conduct of TRC's operations.