Patient Service Representative
Company: Baystate Health
Posted on: May 28, 2023
In collaboration with the multi-disciplinary care team performs the administrative tasks necessary to support exceptional patient-centered care; such as, reception, registration, demographic and insurance verification, answer telephone calls and direct to the appropriate individual, strong customer service skills among patients and multidisciplinary team. As a level three works independently under the supervision of the Practice Supervisor or Manager and takes leadership role on projects and may oversee work of others in leaders absence.
1) Managing the Patient Experience:
Greets patients promptly in warm, friendly manner demonstrating appropriate amount of interest or concern. Smile, make eye contact, use welcoming language (hello, welcome, how can I help you today). To maintain patient confidentiality use the system to verify reason for visit. Gather and/or verify patient demographics. Confirm that we have referrals or pre-authorizations if necessary. Give the patient a provider update (on time or running late, etc.).
Maintain waiting area, check reading materials, play areas, etc. Direct patient and family members to restrooms and other amenities. Check to see if there is any other way you can assist. Employees at this level are comfortable with a wide diversity of patients their families and caregivers and can address concerns and can manage new or unusual situations with tact. Makes recommendations for improving their experience.
2) Insurance Verification:
Request proof of insurance; verify using appropriate systems, initiates contact for financial counseling. Assist patients or customers fill out and complete medical release of information accurately.
Demonstrates understanding of and resolves or offers solutions to problems. Takes the lead on establishing or changing policies and procedures. Understand insurance coverage and understands billing for part A (hospital) and part B (provider). Works with billing issues and charge edits.
Co-payments- Requests, accepts and documents co-payments and payments on account balances and releases change. Secures cash drawer according to departmental procedures. Prepares daily deposit. Prepares deposit slips and submits with payments. Reconciles collections and billing information. Provides a receipt.
Ensures reconciliation of number of visits to billed encounters; communicates to manager and providers unbilled encounters in the holding bin; release charges; processes billing edits to ensure billing deadlines are met.
Assists in the training of new providers on the electronic charge capture system.
Develops and maintains working relationships with coworkers and providers, other agencies and ancillaries. Receives and provides information as necessary while complying with policies and regulations (e.g. HIPPA). Addresses public in a cheerful customer service focused manner. Demonstrates awareness of cultural differences and adjusts to accommodate differences. Manages difficult conversations. Identifies issues and seeks resolution independently.
6) Check out:
Following departmental protocol reviews patient information to ensure patient has necessary information, schedule follow-up/next visits, and provide referrals. Time stamp patient out in appropriate system(s). Depart summary is offered to every patient.
Answers telephones in prompt courteous manner within practice time frames. Routes phone call to appropriate person and/or creates message in system. Works administrative messages and responds or directs calls as appropriate.
Schedules/creates new, follow-up or walk-in appointments according to practice guidelines. Ensures a duplicate medical record number is not created. Makes reminder calls to patients. Cancels appointments managing wait lists and no shows.
9) Mail Processing/Faxes:
Opens, sorts and distributes all incoming mail and faxes daily according to practice guidelines.
Prints orders, letters, or one or two pages medical records (directs or assists in contacting HIM for larter records), obtaining appropriate releases or approvals in compliance with practice policy and regulations (e.g. HIPPA). Prepares documents for scanning.
Works physician schedules ensuring patients are seen in accordance with practice guidelines. Works with physicians and practice manager or supervisor to schedule or reschedule appointments to meet patient or practice needs. Creates physician schedule templates.
Is seen as go to person, takes lead in supervisor's or manager's absence, may oversee distribution of work or scheduling of staff, mentors employees and trains new staff, may provide input to employee evaluations, clarifies office procedures and policies.
13) Interpreter Services:
If approved, provides interpreter services for nurses, providers and social services staff as needed. Accurately interprets questions, information and instructions for patients and providers much of which includes medical terminology. Explain cultural differences to patients and providers to promote understanding and facilitate quality patient care. Translate brief provider instructions for patient/family into target language. Spot translate written documents as necessary to or from target language. Completes one evaluation translation annually.
14) Other Duties-Practice Specific:
Responsibilities may be more specialized than as detailed above in larger practices or may include additional duties in smaller practices (e.g. may Prep Roster, schedule surgery, etc.).
Required Work Experience:
1) Experience or education equivalent to that generally received by obtaining HS graduation
Preferred Work Experience:
1) 3 years relevant, 2 years of which at BH
Skills and Competencies:
1) Medical terminology, keyboard, Microsoft office products, schedule systems, medical records (electronic and paper), billing, basic math, language, reading and writing, customer service
2) If applicable validates interpretation and translation and attends Interpreter in-service meetings as required
You Belong At Baystate
At Baystate Health we know that treating one another with dignity and equity is what elevates respect for our patients and staff. It makes us not just an organization, but also a community where you belong. It is how we advance the care and enhance the lives of all people.
DIVERSE TEAMS. DIVERSE PATIENTS. DIVERSE LOCATIONS.
GED or HiSET (Required)
Equal Employment Opportunity Employer
Baystate Health is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, marital status, national origin, ancestry, age, genetic information, disability, or protected veteran status.
Ab out Baystate Health
Baystate Health (BH) is one of New England's leading and largest integrated health care organizations, serving a population of nearly one million people throughout western New England. With roots dating back to the founding of Springfield City Hospital in 1873, Baystate Health has been providing high-quality and compassionate health care in western Massachusetts for more than 145 years. With more than 12,000 employees, a medical staff of nearly 3,100 physicians, and a net patient service revenue of more than $1.4 billion, the ever-growing health system includes five Massachusetts hospitals and the Baystate Mary Lane Outpatient Center in Ware:
Baystate Medical Center in Springfield
Baystate Children's Hospital (located at Baystate Medical Center)
Baystate Franklin Medical Center in Greenfield
Baystate Wing Hospital in Palmer
Baystate Noble Hospital in Westfield
Keywords: Baystate Health, Springfield , Patient Service Representative, Sales , Belchertown, Massachusetts
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