Reports to: Supervisor, Administrative Clinical Operations
Position Overview:
The Patient Services Representative (PSR) role is responsible for patient flow and appointment scheduling. This highly visible position has extensive patient contact — both in person and by telephone. PSRs are responsible for front desk tasks, including check-in, collecting copays, and obtaining accurate insurance eligibility information. The role is also responsible for administrative tasks, including phone calls, data entry, insurance reviews, filing, and scheduling appointments and procedures to coordinate within and across providers, service areas, and healthcare facilities.
The role interacts with internal and external stakeholders by effectively communicating with referral providers and practices to facilitate management of complex patient issues. PSRs also provide positive and effective customer service that supports departmental operations.
Principal Duties and Responsibilities*
- Greets all patients and family members in a professional and courteous manner.
- Verifies all demographic and insurance information, making changes as necessary.
- Ensures copy of proof of insurance card is taken for all encounters at the time of patient check-in.
- Collects copayments and maintains an accurate cash log of all dollars collected.
- Reconciles payments and prepares deposits, providing an accurate accounting of funds.
- Provides accurate record of transactions within appropriate systems. Facilitates and directs communication to Billing Office when questions of payment ability arise.
- Maintains a working understanding of all health insurance plans, financial services, and self-pay resources, specifically MIT-sponsored health plans and Medicare. Appropriately refers patients to the appropriate customer services when questions arise regarding benefits or other issues.
- Maintains basic knowledge of medical terminology and ICD10 coding.
- Rotates through check-in and telephone roles in a predetermined frequency.
- Manages both inbound and outbound phone calls, emails, and/or other standard patient inquiries by answering, screening, and routing inquiries as dictated by service area workflows.
- Records messages in appropriate tracking log(s) and forwards messages according to triage standards and/or other urgent information or services.
- Responds to requests for routine information or assistance within scope of knowledge and authority. Triages and manages more complex telephone calls while using courteous customer service skills. Contacts emergency services when required.
- Answers all incoming calls that arrive at the service desk for clinicians, takes messages, and routes appropriately.
- In the event of a patient emergency, notifies provider or takes steps to locate on-call providers.
- Assists service area clinicians in returning telephone calls, calling in prescriptions, and informing patients of results as requested.
- Prepares correspondence for patients and physicians when required.
- Works directly with each patient (or their HIPAA-approved representative) to schedule and record all encounter appointments, communicates patient confirmation and reminders as established by service area standards.
- Coordinates patient visits with other MIT Health Specialties, diagnostic testing, and/or off-site practices to ensure that patients are seen in a timely manner. Communicates with primary care provider or designee when necessary to solve scheduling roadblocks.
- Processes all necessary referrals and follows up on all insurance questions and inquiries as needed.
- Opens, sorts, and processes all incoming and outgoing mail.
- Other duties as assigned.
Minimum Required Education and Experience:
- High school diploma or GED equivalent required.
- Minimum two years of previous experience such as customer service or administrative role required. Prior experience in a healthcare setting a plus.
- Able to perform multiple tasks simultaneously.
- Able to communicate with patients, clinicians, and other professional staff in pleasant, calming, and diplomatic manner.
- Strong organizational skills and the ability to follow through and complete tasks.
- Math skills; ability to add, subtract, multiply, and divide with accuracy.
- Able to work independently or within a team environment.
- Able to work with diverse internal and external constituencies.