Patient Services Representative, Urgent Care

Patient Services Representative, Urgent Care

Reports to: Supervisor, Administrative Clinical Operations

Position Overview: 

The Patient Services Representative is responsible for patient flow and appointment scheduling. This highly visible position has extensive patient contact, both in person and by telephone. Responsible for front desk (check-in, collecting co-pays, obtaining accurate insurance eligibility information, etc.) and administration (phone calls, data entry, insurance reviews, filing, etc.) and scheduling appointments and procedures to coordinate within and across providers, service areas, and institutions. Collaborates by effectively communicating with referral providers and practices to facilitate the management of complex patient issues. Provides 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 a copy of proof of insurance card is taken for all encounters at the time of patient check-in. 
  • Collects co-payments and maintains an accurate cash log of all dollars collected. 
  • Reconciles payments and prepares deposits, accurately accounting for funds. Provides an accurate record of transactions within appropriate systems. Facilitates and directs communication to the Billing Office when questions of payment ability arise.
  • Maintains a working understanding of all health insurance plans, financial services, and self-pay resources, specifically focusing on those sponsored by MIT and Medicare. Appropriately refers patients to Health Plans Member Services when questions arise regarding benefit and referral issues. Maintains basic knowledge of medical terminology and ICD10 coding 
  • Rotates through the check-in and telephone roles using a predetermined frequency.
  • Manages 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 said messages as per standards for triage 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, utilizing courteous customer service skills. Initiating calls for emergency services as required.
  • Answers all incoming calls that arrive at the service desk for clinicians, takes messages, and routes appropriately. 
  • Notifies providers or takes steps to locate covering providers for patient emergencies.
  • 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. 
  • Working directly with each patient (or their HIPAA-approved representative), scheduling and recording all encounter appointments, and communicating 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 escalate 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 health care setting a plus.
  • Ability to perform multiple tasks simultaneously.
  • Effective telephone manner and ability to communicate with patients, clinicians, and other professional staff in a pleasant, calming, and diplomatic manner.
  • Strong organizational and follow-through skills.
  • Math skills: ability to add, subtract, multiply, and divide with accuracy.
  • Ability to work independently or within a team environment.
  • The ability to work with diverse internal and external constituencies.

Will be required to work twelve-hour shifts and weekends.

Job number: 23931
Grade level: 4

* To comply with regulations by the Americans with Disabilities Act (ADA), the principal duties in job descriptions must be essential to the job. To identify essential functions, focus on the purpose and the result of the duties rather than the manner in which they are performed. The following definition applies: a job function is essential if removal of that function would fundamentally change the job.

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