Senior Patient Services Representative - Primary Care (Medical Center)

Senior Patient Services Representative

At Houston Methodist, the Senior Patient Services Representative is responsible for performing patient check in / check out functions and appointment scheduling to facilitate the patient visit experience. Responsibilities include performing more complex processes related to scheduling or other department related protocols and serving as a role model and mentor to less experienced staff. This position supports timely, accurate claims submission and may perform registration and / or other revenue cycle functions. Other duties include providing general operations assistance and / or patient service tasks specific to the scope of the department.

Houston Methodist Standard

PATIENT AGE GROUP(S) AND POPULATION(S) SERVED

Refer to departmental "Scope of Service" and "Provision of Care" plans, as applicable, for description of primary age groups and populations served by this job for the respective HM entity.

HOUSTON METHODIST EXPERIENCE EXPECTATIONS

Provide personalized care and service by consistently demonstrating our I CARE values :

Integrity : We are honest and ethical in all we say and do.

Compassion : We embrace the whole person including emotional, ethical, physical, and spiritual needs.

Accountability : We hold ourselves accountable for all our actions.

Respect : We treat every individual as a person of worth, dignity, and value.

Excellence : We strive to be the best at what we do and a model for others to emulate.

Practices the Caring and Serving Model

Delivers personalized service using HM Service Standards

Provides for exceptional patient / customer experiences by following our Standards of Practice of always using Positive Language (AIDET, Managing Up, Key Words)

Intentionally collaborates with other healthcare professionals involved in patients / customers or employees' experiential journeys to ensure strong communication, ease of access to information, and a seamless experience

Involves patients (customers) in shift / handoff reports by enabling their participation in their plan of care as applicable to the given job

Actively supports the organization's vision, fulfills the mission and abides by the I CARE values

Responsibilities

PEOPLE ESSENTIAL FUNCTIONS

Contributes to a positive work environment and to a dynamic, team focused work unit that actively helps one another to achieve optimal department results. Collaborates with all members of the interprofessional health care team by actively communicating and reporting pertinent patient care information and data in a comprehensive manner.

Performs patient check in / check out functions. Obtains and inputs accurate scheduling and registration data to initiate financial clearance activities as needed. Performs more complex processes related to scheduling or other clinic related protocols.

Coordinates patient flow as directed with consistency, timeliness, and expert skill while meeting appropriate priority standards. Provides appropriate notification of issues that may result in service delays or denials. Handles add-ons, reschedules, and cancellations appropriately and as per department protocol.

Functions as a role model and mentor for less experienced staff and serves as the next level resolution source for problems.

SERVICE ESSENTIAL FUNCTIONS

Uses excellent communication skills (verbal, non-verbal, written) to facilitate providing the highest quality service during every patient, physician, guest, employee, or other encounter. Responds promptly to requests by staff, patients, physicians, and other members of the patient care team. Recognizes and responds appropriately to urgent / emergent situations per protocols.

Contributes to patient, employee and physician satisfaction as well as effective revenue cycle process.

Generates reports and assists with department correspondence. Provides other administrative assistance as directed.

QUALITY / SAFETY ESSENTIAL FUNCTIONS

Serves as a liaison for the patient, medical staff, and third parties. Communicates to resolve patient access and quality service matters. Keeps open channels of communication with physician, patient, and service areas regarding action taken and resolution.

Enters patient and operational data into various database systems with a high level of thoroughness, accuracy and timeliness.

Ensures patient information is conveyed to others appropriately while complying with patient confidentiality and HIPAA regulations. May assist clinical staff as per scope of the treatment center.

FINANCE ESSENTIAL FUNCTIONS

Accurately records information when performing functions such as charge entry, registration, scheduling, insurance verification / coordination, or obtaining authorizations or referrals to ensure financial objectives are met. Conducts front end revenue cycle duties as directed. Educates patients and others regarding billing processes and potential financial responsibilities as necessary.

Organizes time effectively, minimizing incidental overtime, and sets priorities. Utilizes time between heavy workloads efficiently and helps other team members.

Uses department resources / equipment / supplies properly and efficiently. Participates in inventory management by taking action to ensure supply levels are adequate.

GROWTH / INNOVATION ESSENTIAL FUNCTIONS

Displays initiative to improve job functions; offers suggestions to streamline process for efficient patient flow and other quality or service matters.

Seeks opportunities to expand learning beyond baseline competencies with a focus on continual development.

This job description is not intended to be all-inclusive; the employee will also perform other reasonably related business / job duties as assigned. Houston Methodist reserves the right to revise job duties and responsibilities as the need arises.

Qualifications

EDUCATION

High School diploma or equivalent education (examples include : GED, verification of homeschool equivalency, partial or full completion of post-secondary education, etc.)

WORK EXPERIENCE

Five years of experience to include three years experience in a related role within healthcare

License / Certification

LICENSES AND CERTIFICATIONS - REQUIRED

N / A

KSA / Supplemental Data

KNOWLEDGE, SKILLS, AND ABILITIES

Demonstrates the skills and competencies necessary to safely perform the assigned job, determined through on-going skills, competency assessments, and performance evaluations

Sufficient proficiency in speaking, reading, and writing the English language necessary to perform the essential functions of this job, especially with regard to activities impacting patient or employee safety or security

Ability to effectively communicate with patients, physicians, family members and co-workers in a manner consistent with a customer service focus and application of positive language principles

Strong customer service, phone and scheduling skills

Basic computer skills in word processing applications and ability to utilize software systems such as the electronic medical record

Knowledge of basic medical terminology

Ability to analyze and solve problems

Working knowledge of revenue cycle components and insurance requirements for reimbursement

SUPPLEMENTAL REQUIREMENTS

WORK ATTIRE

Uniform No

Scrubs No

Business professional Yes

Other (department approved) No

ON-CALL

• Note that employees may be required to be on-call during emergencies (ie. DIsaster, Severe Weather Events, etc) regardless of selection below.

On Call

TRAVEL

May require travel within the Houston Metropolitan area No

May require travel outside Houston Metropolitan area No

Company Profile

With locations throughout the Greater Houston area, Houston Methodist Primary Care Group (HMPCG) is dedicated to providing quality patient care for the entire family. HMPCG is proud to be a part of Houston Methodist and its family of hospitals, ensuring efficient access to specialty and hospital services whenever the need arises. As members of the Greater Houston community, HMPCG is committed to the well-being of its patients, providing the right care at the right time in convenient locations throughout the Houston area.