Patient Services Representative-Referrals Support

JOB TITLE: Patient Services Representative Referrals Support

REPORTS TO: Practice Manager

INTERRELATIONSHIPS: All office staff at all LRHC sites patients insurance companies outside physician offices

EDUCATION: Some level of formal training (Certificate Associates or Bachelors degree) preferred. High School Diploma or equivalent required.

WORK EXPERIENCE: Previous experience working in a healthcare office or in a healthcare setting involving the use of health information technology and customer service. Must have attention to detail; excellent written and verbal communication skills; knowledge of general office equipment; and ability to prioritize multitask and organize projects.

PHYSICAL DEMANDS: Able to effectively perform a combination of computer telephone and miscellaneous desk work; perform repetitive tasks; attend meetings within clinic and at other Little Rivers Health Care (LRHC) sites; normal range of hearing and vision with or without reasonable accommodation to record and communicate with patients and co-workers effectively; walk the equivalent of two miles per day; moderate degree of manual dexterity; ability to grip bend reach above shoulder level kneel squat sit for prolonged periods of time and lift up to 30 pounds. Must be able to concentrate assist with problem resolution and work alone or as part of a team.

REFERRALS SUPPORT & RESPONSIBILITIES:

1. Assist/cover for Referral Coordinator.

2. Research outgoing referrals and diagnostic orders including the completion of required forms.

3. Tracking of referrals/diagnostic orders via phone/access though outside facility EMR system.

4. Coordinating and scheduling referrals and diagnostic orders.

5. Prioritizes referrals and diagnostic orders by their urgency in a timely manner.

6. Contacts insurance companies to ensure if prior approval requirements are met to include documentation.

7. Establishes relationships with outside facilities.

DUTIES & RESPONSIBILITIES:

1. Responsible for unlocking front door at appropriate time.

2. Check voice mail for messages and turn on/off as appropriate.

3. Answer telephone take messages and transfer calls as appropriate.

4. Take prescriptions refill requests from patients and pharmacies and enter into the computer

5. Check patients in and out upon arrival and departure respectively.

6. Schedule patient appointments.

7. Print demographic information sheets at least annually for patient to verify information.

8. Enter patient demographics information into computer.

9. Update patient demographic/insurance information as necessary.

10. Scans patient insurance cards into EHR as necessary.

11. Collect co-pay and/or billed charges from patient at time of visit and post into EHR.

12. Process all received faxes appropriately and in a timely manner.

13. Process courier mail in a timely manner.

14. Run insurance eligibility program twice a day- once for the day before the appointment and once for same day appointments.

15. Verify Medicaid eligibility via website for patient upon arrival as required.

16. Telephone following day patients to confirm appointments if automated system fails.

17. Make outside referral appointments for patients as needed.

18. Monitor outstanding referrals and follow-up as needed to ensure patient attends appointment and we receive the report.

19. Responsible for printing and tracking dictation daily.

20. Process documents from provider out-box for office as appropriate.

21. File patient charts as necessary.

22. Reconcile cash drawer daily and prepare deposit report for Practice Manager.

23. Maintain administrative patient alerts as necessary.

24. Assemble registration packets as needed.

25. Prepare documentation for OB Chart Review monthly.

26. Assist with Medical Records as necessary.

27. Assist Referral Coordinator/Coverage with tracking of all referrals and diagnostic orders sent to outside facilities to include completing required forms tracking phone communication direct access with outside facility EMR system and scheduling.

28. Perform other duties as assigned.