Patient Service Representative

Ambulatory Access Patient Service Representative

Reports To Position : Applicable Ambulatory Access Leader

Department : Patient Access Services

Date Last Reviewed : October 2024

Our Vision : Creating America's healthiest community, together

Our Mission : In the spirit of love and compassion, better health, better care, better value

Our Values : Accountability, Caring and Teamwork

Departmental Summary : Patient Access Services is a support services division of St Charles Health System. Patient Access serves as a liaison to inpatient and hospital-based outpatient departments. Ambulatory Access serves as a liaison to ambulatory outpatient departments by providing scheduling, registration, prior authorization, medical record, population health outreach, and project management support. We encourage collaboration between clinical and non-clinical staff to ensure we are providing our community with comprehensive and compassionate health care.

Position Overview : The Patient Services Representative (PSR) acts as liaison between patients and the clinical staff by facilitating clerical, reception, scheduling, and registration duties. PSRs assist with various operational administrative tasks in support of the clinic operational needs. PSRs collaborate with clinical staff to ensure we are providing our community with comprehensive and compassionate health care. This position does not directly manage any other caregivers.

Essential Functions and Duties :

Accurately schedules patients based on department scheduling guidelines, maximizing patient access and provider utilization.

Performs full registration at the time of scheduling.

Uses electronic health system to maintain department appointment requests, waitlist and follow up reports.

Performs real time eligibility (RTE) for insurance benefits.

Uses RTE information gathered from the EHR or payer portals to accurately route scheduling requests or schedule appointments.

Ensures authorization is linked to all appointments at the time of check in.

Reconciles daily schedules with appointment reports.

Responsible for addressing registration related work queue items that require resolution prior to encounter closure.

Responsible for accurately recording patient demographics, insurance and billing information at the time of scheduling, check in, and check out.

Courteously and confidently request appropriate patient payments from patients / guardians. Accurately process all payment types (copays, co-insurance, prepayment, deductible, self-pay balances) and completes daily deposits and batch reports.

At the time of check out, provides patient with printed After Visit Summary upon request, schedules follow up services as needed, collects any copay that remains due for the day's services.

Maintains patient access related departmental files, programs and lists.

Performs daily readiness activities such as turning on computers, equipment, kiosks, readying patient waiting areas and check in areas, ensuring supplies are fully stocked.

Assists with processing and resolving incoming and outgoing electronic and telephone messages, worklist entries and basic work queue items within the electronic health record in accordance with established protocols.

Responsible for supporting the basic functions of document collection and distribution, locating and distributing patient documents and information to appropriate staff members.

Faxing, scanning, indexing medical records into document management system.

Opening and distributing incoming mail and paper faxes.

Supports project-based patient outreach initiatives. Engages with creation of standard work and patient-centered protocols.

Delivers customer service and / or patient care in a manner that promotes goodwill, is timely, efficient, and accurate.

Supports the vision, mission, and values of the organization in all respects.

Actively participates in achieving organizational and department goals.

Ability to work as part of a Care Team with providers and clinical staff.

Provide direction and assistance to patients as needed.

Responsible for processing telephone calls and electronic messages accurately in accordance with established protocols.

Facilitate scheduling of, or arrange for interpretive services for patients as needed.

Supports Lean principles of continuous improvement with energy and enthusiasm, functioning as a champion of change.

Provides and maintains a safe environment for caregivers, patients, and guests.

Supports the onboarding process of new caregivers to the same role, assisting with training and shadowing as needed.

Conducts all activities with the highest standards of professionalism and confidentiality.

Complies with all applicable laws, regulations, policies, and procedures, supporting the organization's corporate integrity efforts by acting in an ethical and appropriate manner, reporting known or suspected violation of applicable rules, and cooperating fully with all organizational investigations and proceedings.

May perform additional duties of similar complexity within the organization, as required or assigned.

Education :

Required : High school diploma or GED.

Preferred : N / A

Licensure / Certification / Registration :

Required : Ability to travel to business functions / trainings / meetings and all St. Charles Health System worksites.

Preferred : N / A

Experience :

Required : One (1) year of clerical support in a healthcare setting.

Preferred : Basic medical terminology. Prior customer service experience.

Personal Protective Equipment :

Must be able to wear appropriate Personal Protective Equipment (PPE) required to perform the job safely.

Additional Position Information :

Must have excellent communication and organizational skills with ability to interact with a diverse population and professionally represent St. Charles Health System with internal and external sources.

Must adapt quickly to frequent process changes and improvements.

Is reliable, engaged, and provides feedback as to improve processes and policies.

Attends all department, team, and company meetings as required.

Requires exceptional critical thinking and analytical skills with the ability to work under minimal supervision.

Requires strong communication, customer service interpersonal skills and telephone etiquette.

Ability to prioritize workflow according to pre-set instructions.

Strong teamwork and collaborative skills.

Excellent organizational skills, written and oral communication and customer service skills, particularly in dealing with stressful personal interactions.

Ability to multi-task and work independently.

Attention to detail.

Performs basic math (add, subtract, multiply and divide) calculations.

Performs intermediate to advanced math (analysis, statistics, significant data or number manipulation).

Basic to intermediate ability and experience in computer applications, specifically electronic medical records system and MS Office.

May cover multiple locations and specialities outside of home department.

Must have the ability to adapt to meet operational support needs at any SCHS location.

Physical Requirements :

Continually (75% or more) : Use of clear and audible speaking voice and the ability to hear normal speech level.

Frequently (50%) : Sitting, standing, walking, lifting 1-10 pounds, keyboard operation.

Occasionally (25%) : Bending, climbing stairs, reaching overhead, carrying / pushing or pulling 1-10 pounds, grasping / squeezing.

Rarely (10%) : Stooping / kneeling / crouching, lifting, carrying, pushing or pulling 11-15 pounds, operation of a motor vehicle.

Never (0%) : Climbing ladder / step-stool, lifting / carrying / pushing or pulling 25-50 pounds, ability to hear whispered speech level.

Exposure to Elemental Factors :

Never (0%) : Heat, cold, wet / slippery area, noise, dust, vibration, chemical solution, uneven surface.

Blood-Borne Pathogen (BBP) Exposure Category :

No Risk for Exposure to BBP

Schedule Weekly Hours : 40

Caregiver Type : Regular

Shift : First Shift (United States of America)

Is Exempt Position? No

Job Family : REPRESENTATIVE

Scheduled Days of the Week : Monday-Friday

Shift Start & End Time : variable