The Patient Service Representative acts as the primary liaison for the clinic, facilitating the complete patient encounter lifecycle from initial scheduling and registration through financial processing and check-out. This role serves the department by ensuring operational efficiency and data accuracy, including payment collection. Ultimately, this position supports the College's mission by providing seamless administrative support and high-quality customer service.
Essential Duties and Responsibilities
A. Front Office & Patient Flow
- Customer Service: Serves as the first point of contact, answering phones in a professional manner, greeting all patients upon arrival, and confirming appointment times.
- Patient Flow: Directs patients to appropriate clinical areas to ensure smooth operational activity and monitors the waiting room to maintain safety and cleanliness standards.
- Communication: Explains walk-in and appointment procedures to prospective patients, referral sources, and the general public.
- General Admin: Opens and sorts incoming mail and pulls medical records for telephone inquiries as needed.
B. Scheduling & Registration
- Appointment Management: Accurately schedules new and return patient appointments based on physician or student doctor availability and medical specialty protocols.
- Registration: Obtains, verifies, and records patient demographic and insurance information required by the appointment system.
- Insurance Verification: Verifies financial eligibility for all scheduled patients and obtains necessary authorization based on specific insurance requirements.
- Maintenance: Performs scheduling maintenance as required, coordinates referral appointments, and confirms all appointments 48 hours in advance.
C. Financial & Revenue Cycle
- Collections: Responsible for point-of-service collections, including co-payments, deductibles, non-covered services, and self-pay balances.
- Cash Handling: Receives and processes payments according to cash management policy; balances the cash drawer at the end of every shift/day using the daily balancing proof sheet.
III. Knowledge, Skills, and Abilities
A. Technical Knowledge & Medical Office Skills
- Medical Terminology: Sufficient proficiency in medical terminology to accurately identify and explain medical procedures to patients, third-party payers, and facility personnel.
- Coding & Billing: Knowledge of CPT/CDT and current ICD coding standards (e.g., ICD-10).
- Insurance Proficiency: Sufficient knowledge of insurance plans to correctly interpret patient financial information and assess the need for prior authorizations and referrals.
- Office Procedures: Thorough understanding of general medical office procedures and protocols, including familiarity with substance abuse treatment environments.
- Records Management: Strict adherence to patient confidentiality standards (HIPAA) and release of information protocols; ability to file accurately using numerical and alphabetical systems.
- Technology: Proficiency with standard office hardware (computers, copiers, fax machines) and software applications.
B. Professional Attributes & Communication
- Communication: Excellent oral and written communication skills, with professional and courteous telephone etiquette.
- Customer Service: Ability to interact positively and professionally with the general public, staff, and clients.
- Work Ethic: Skilled at managing multiple priorities and working effectively under pressure in a busy clinical environment.
IV. Minimum Qualifications (Placeholder)
- Education: High School Diploma or GED required. Associate's degree or relevant certification (e.g., Medical Office Specialist) preferred.
- Experience: One (1) to two (2) years of experience working in a fast-paced medical office, clinic, or hospital setting required.
V. Physical Demands and Working Environment (Placeholder)
- Work is performed primarily in a standard office environment, frequently requiring the use of office equipment.
- Requires prolonged sitting, standing, and walking, as well as lifting and carrying supplies up to 20 pounds.