SCOPE OF POSITION
The Patient Service Representative is responsible for answering all incoming calls and routing to appropriate individual. Scheduling patient appointments and maintaining proper scheduling information for individual physicians. Responsible for data retrieval of patient information from computer data base for daily appointments and telephone calls. This could include making charts, filing of charts and medical records, copying chart forms, pulling charts with reports for the physicians to sign off on, purging charts and pulling charts for audit purposes. Also responsible for updating any data for established patients. Records and maintains all patient names, account numbers and chart numbers on a back-up listing to be used in the event of computer down time. Receives payments and codes encounter forms with proper payment distribution, CPT & ICD-9 codes. Patient Service Representative will greet patients, ascertain nature of business and direct patient or visitor to the appropriate person. Receives and registers patients in a courteous and friendly manner. Responsible for verification of insurance plan to ascertain provider participation and co pay requirements. Requires copying of insurance cards and medical records as appropriate. Handle fatal error reports and refilling of insurance claims. Performs precertification and referral functions as required by individual insurance plans. Responsible for the comprehensive and compassionate collection of all financial and clinical information necessary to effectively register a patient for services at the practice location which includes financial screening and counseling, collecting co pays, data entry of office visit charges and also collection of unpaid balances. Reconcile daily charge sheets. Count cash drawers daily, prepare bank deposits of individual entries on a daily basis, balance credit cards daily, responsible for daily closing procedure of his/her entries and ensuring proper account balance, secure all cash at the end of the day and prepare for night deposits. Check for missing tickets at the end of the day. Miscellaneous duties may include distributing the mail, faxing and mailing medical records and securing the office doors at the end of the day. May require knowledge and use of up to three computer systems: Medic, SMS and Systoc (depending on practice location).
MSHA expects all team members to support the VOS initiative by demonstrating awareness of the VOS system and effectively applying it to his/her work.
Job duties of this position may require access to protected patient information (PHI). The team member will be accountable for appropriate use of the record and compliance with all confidentiality and security policy and procedures related to use, access, and disclosure of PHI.
REPORTING RELATIONSHIP
The Patient Service Representative reports directly to the Office Manager. In the outpatient clinics at Indian Path Pavilion and Woodridge Hospital, this position reports directly to the Behavioral Health Outpatient Program Manager.
EDUCATION EXPERIENCE
This position requires a high school diploma or General Education Degree (GED). Data entry and computer skills essential. Knowledge of CPT and ICD-9 codes and billing beneficial. Attendance in both CPT/ICD-9 classes mandatory in first six months of employment. Some experience with the Medic System is preferred (may also require some experience with Systoc and SMS). This individual is entrusted with confidential medical and financial information. Team member will have access to checks and cash submitted to the medical practice. Must be able to communicate effectively with office staff, nurses and physicians. Must have knowledge of current software or willingness to learn. Must be able to attend seminars related to job and share the information and knowledge to co-workers and appropriate medical clinics. Must be able to interact closely with the public.
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