Patient Services Representative

POSITION SUMMARY:

Greets patients and ensures a complete and accurate check-in and check-out process for patients. Obtains all data elements necessary to process patients claim for insurance benefits and for accurately billing patient for any co-payments, deductibles and non-covered services.  

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Acknowledges patient upon their arrival and greets them in a friendly, professional manner.
• Obtains or updates patients demographic information and copies insurance cards at every visit.
• Correctly enters all required data elements into the physician practice management system.
• Answers patient and family member questions as needed and appropriate.
• Follows appropriate workflow processes for check in and check out. Pulls routine eye plans and obtains authorizations (VSP, EyeMed, Community Eye Care).
• Verifies and reviews eligibility in NextGen and all payer sites as necessary. Files Charges in NextGen and routine vision system (VSP).
• Accurately calculates patient charges and collects required co-payments for services rendered.
• Monitors missing charges in NextGen and work with clinical teams to get charges entered in a timely fashion.
• Prepares charts by performing pre-registration review; Prepare any charts where physician may travel to occasional location (ie. Washam); Prepare premature baby charts.
• Floats between Check-In and Check-Out in order to ensure that coverage corresponds to patient volume.
• Provides support to technical staff and physicians as required to ensure timely flow of patients through the system.
• If assigned bilingual responsibilities, monitors all Spanish NotifyMD web messages. Handles all Spanish calls and voicemails. Reviews and approves translated correspondence and patient forms. Serves as translator for Surgery Coordinators when needed.
• Scans correspondence received in mail or fax to Cotswold.
• Schedules patient appointments including triage patients. Schedules web appointments that have been requested by patients.
• Uses multiple practice management systems to extract information.
• Complies with petty cash policy daily.
• Prints physician schedules for clinical teams.
• Faxes referrals received to the referral department. Distributes faxes.
• Answers telephone in a timely manner in a customer friendly manner. 

MINIMUM QUALIFICATIONS:

• High school diploma or equivalent.
• Two (2) years of customer service experience, preferably in a medical/ophthalmic environment.
• Basic database skills, preferably in an electronic medical system.
• Knowledge of insurance company processes and ability to read an Explanation of Benefits form.
• Ability to work independently.
• Ability to clearly communicate, both in writing and verbally.
• Excellent interpersonal skills with a variety of personality types.
• Ability to multi-task.
• Ability to problem solve.
• Organizational skills.