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Patient Care Representative

Patient Care Representative

PCC Community Wellness CenterBerwyn, IL, US
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Office Manager

Location : South Family Health Center - Berwyn, IL

Position Type : Full Time

Education Level : High School / GED

Salary Range : $16.60 - $18.60 Hourly

Travel Percentage : Local - Location to Location

Job Shift : Day

Job Category : Health Care

Job Summary

Responsible for the operations of the reception area, registering and scheduling of patients, collecting co-pays and money charged for services rendered and handling all patient inquiries.

Essential Duties and Responsibilities

Greets all patients, staff, visitors, and vendors in a professional and welcoming manner.

Schedules appointments in order to track billing slips to ensure charge capture occurs.

Prepares for day, reviews Eligibility and Phone report, prepares any new patient charts and / or paperwork at patient presentation.

Performs registration in clinic setting and via telephone to ensure demographic and insurance information is accurate and complete.

Obtains copies of insurance cards, drivers license, authorizations, and referrals and scan or enter them into electronic health record.

Ensures all requirements and fields noted on the Check-In and Check-Out page are satisfied and complete.

Collects co-payments and outstanding balances at Check-In, and time of service balances and estimated balances at Check-Out according to policy.

Reviews and complies with Patient Account Notes and Appointment Notes in electronic health record.

Refers patients to Financial Counselors regarding past due balances, questions and / or resolution that PCRs are unable to answer.

Processes claim creations in electronic health record at Check-Out.

Submits appropriate claims for Real Time Adjudication.

Works Day End Review report and designated Tier-based HOLD Claim Worklist(s) on a daily basis.

Accepts accountability for all Worklists on the dashboard or elsewhere based on assignment.

Answers the telephone directing calls to appropriate areas or takes messages and relays them to the appropriate staff member as necessary.

Informs patient of privacy policies and procedures.

Informs patients of delays in physician schedules, assists with patient comfort while delayed.

Schedules follow-up appointments, creates appointment ticklers in electronic health record, and works associated Worklists relative to both based on assignment.

Creates a Time of Service batch and links it to a deposit batch daily.

Reconciles, balances, and closes each batch / drawer at end of day.

Turns over batches to the designated resource daily.

Covers for other staff in reception, including other office locations.

Processes all releases for medical information ensuring appropriate consents are completed, adhering to PCCs HIPAA and privacy guidelines.

Drives continual quality improvement through participation in organizational quality improvement efforts that may include but are not limited to patient satisfaction, clinical and operational quality improvement initiatives.

Maintains a neat and orderly work area.

Performs other duties as assigned.

Qualifications

Experience / Training :

  • High school diploma or equivalent
  • 1 - 2 years EMR experience in medical setting preferred
  • Constantly communicates with patients, families, and other healthcare providers. Must be able to exchange accurate information in these situations.
  • Proficient in MS Office Business Applications to include : Outlook, Word, PowerPoint, and Excel.

Certifications / Licenses :

  • None
  • Physical Demands :

  • Must be able to remain in a stationary position 50% of the time.
  • Must be able to move around the clinic site 50% of the time.
  • Constantly operates a computer, computer printer, copy machine, and telephone.
  • Occasionally positions self to maintain exertion of physical strength to move objects of 10 pounds from one level to another.
  • Must be able to transport from one site to another.
  • Must be able to cover other shifts as necessary.
  • Other Skills :

  • Ability to read and write proficiently using the English language.
  • Constantly communicates with other healthcare providers. Must be able to exchange accurate information in these situations.
  • Follow-through, assume responsibility and use good judgment.
  • Maintain professionalism under stressful situations.
  • Self-motivated and directed with the ability to prioritize and work efficiently under pressure.
  • Ability to understand and follow verbal and written communication.
  • Detail oriented with the ability to work with minimal / no supervision.
  • Willingness to be part of a team-unit and cooperate in the accomplishment of departmental goals and objectives.
  • Effective and creative problem solving.
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