Patient Services Representative III

Job Summary

The Patient Services Representative III serves as the first point of contact for patients while also supporting optical services. This role is responsible for delivering exceptional customer service, coordinating appointments, managing patient records, verifying insurance, and assisting patients with eyewear selection and optical needs. The position plays a vital role in ensuring smooth clinic operations and a positive patient experience from check-in to checkout.

Essential Duties and Responsibilities

Patient Services Representative

• Greet patients promptly and professionally in person and by phone
• Schedule, confirm, and manage optometry appointments
• Serve as the primary contact for patient inquiries related to eye exams, medical eye care, glasses, and contact lenses
• Verify patient demographics, vision, and medical insurance eligibility, and benefits
• Collect co-pays, payments, and assist patients with billing questions
• Maintain accurate patient records using Electronic Medical Records (EMR) systems
• Scan, file, and manage medical and optical documentation
• Maintain patient confidentiality and comply with HIPAA regulations
• Communicate effectively with optometrists, technicians, and optical staff to ensure seamless patient care

Optical Services

• Assist patients with frame selection, lenses, and eyewear options based on prescriptions and lifestyle needs
• Explain lens types, coatings, and vision correction options in a clear and patient-friendly manner
• Process optical orders, including frames, lenses, and contact lenses
• Adjust, fit, and troubleshoot eyeglasses as needed
• Ensure accuracy of prescriptions and optical measurements (training provided if needed)
• Maintain cleanliness and organization of the optical area and displays
• Assist with inventory management and restocking of frames and optical supplies

Customer Service & Team Support

• Demonstrate empathy, patience, and professionalism when assisting patients
• Support clinic flows during high-volume periods by assisting in both the front desk and optical areas
• Participate in staff meetings, training sessions, and performance evaluations
• Uphold the organization's mission, values, and Code of Ethics
• Perform other duties as assigned

Education and Experience

• High school diploma or equivalent required
• Experience in an optometry, optical, medical office, or customer service setting preferred
• Previous optical sales or eyewear experience is a plus, but not required

Minimum Qualifications

• Strong verbal and written communication skills
• Excellent customer service and interpersonal abilities
• Ability to multitask in a fast-paced clinical environment
• Basic understanding of medical and optical terminology preferred
• Knowledge of vision insurance plans (VSP, EyeMed, Medicaid, Medicare, etc.) is beneficial
• Proficient computer skills, including MS Word, Excel, Outlook, and EMR systems
• Ability to maintain professionalism during challenging patient interactions
• Commitment to ethical standards and patient confidentiality
• Willingness to learn optical systems, measurements, and eyewear products
• Ability to work flexible hours based on clinic needs

Professional Standards

• Leadership

• Team building mentality is exemplified in all work done.

• Positively influence and uplift members and other affiliates.

• Employee Expectations

• Follow all policies and procedures, including the Code of Conduct, which can be found in the Employee Handbook.

• Follow the direction given by the supervisor to ensure site expectations are met.

• Communication

• Must be able to provide important and relevant site information in staff meetings and to members, co-workers, and supervisors.

• Must be able to listen to co-workers and team members.

• Must be able to present important and relevant site information to supervisors.

• Must be able to write and compose clear, concise, accurate written documentation and data reports, as necessary.

Values

Upholds the Code of Ethics and mission of Valley Health Care, Inc. by conducting professional activities with Valley Health Care's values of integrity, teamwork, compassion, excellence, and Here for Good.

Integrity

We act openly and truthfully in everything we do.

Teamwork

We work together to serve our patients.

Excellence

We create better ways of doing the things we do and provide the highest quality of care for each patient every time.

Compassion

We treat each other and our patients with concern, kindness, and respect.

Here for Good

We make decisions that will best serve our patients now and in the future.

Understanding of Health Care Laws and Regulations

Must have the ability to follow HIPAA guidelines as well as an understanding of policies and procedures regarding medical records put in place by the Federal Government, Medicaid, Medicare, and WV Behavioral Health Laws put forth by the WV Department of Health and Human Resources.

Customer Service

Must listen to the customer, understand the customer, do what needs to be done to meet the customer's expectations, and take ownership of the customer experience.

Computer Literacy

Knowledge of basic computer software (MS Office - Word, Excel, and Outlook) and the willingness and ability to learn electronic medical records software.

Reasoning Ability

Must demonstrate the ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret various instructions furnished in written, oral, diagram, or schedule form.

Teamwork

An essential element is the ability to work and interact effectively and positively with other staff members to build and enhance teamwork in the VHC organization; team engagement is necessary to be successful in this position.

Work Record

A demonstrated work record showing good attendance, punctuality, dependability, and the ability to collaborate well with supervisors and coworkers as part of a team effort is essential. A medical office setting is an environment that requires the ability to relate to all types of people while always maintaining a professional demeanor.

Language Skills

Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. The ability to write routine reports and correspondence. The ability to speak effectively to patients or employees of the organization.

Mathematical Skills

Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.

Additional Skills

Must be able to read and interpret medical and work environment-related documents involving patient care, program descriptions, government regulations, and VHC policy and procedures.

Sensitivity to Needs of Special Populations

Must be able to demonstrate an understanding and sensitivity to cultural differences and needs of VHC patients and be able to respond appropriately to all people regardless of race, ethnicity, language, age, sex or sexual orientation, religion, disability, economic standing, etc.

Physical Demands

The physical demands described here represent those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee may be required to drive, sit and stand for extended periods of time; handle papers, type and operate computer equipment; reach with hands and arms; talk in-person, on the telephone, and by electronic means; see and hear, and lift up to twenty-five pounds.

Work Environment

Work is performed in a typical outpatient clinic environment and at locations outside the office. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions of the job.