Patient Service Representative

Job Title
Patient Service Representative
Job ID
Los Alamitos,  CA 90720
Other Location
JOB SUMMARY:  Schedule appointments for all providers, obtains all information concerning to appointment scheduling, verifies insurance eligibility.
•           High school diploma required
•           College education or trade school preferred

•           Experience working in a physician group practice preferred.
•           Proficiency in computer automation, with emphasis on email/internet applications.
•           Knowledge of practice management and word processing software
•           Ability to multitask and perform in high stress/fast-paced work environment.
•           Maintain neat, professional appearance and possess a positive disposition.
•           Strong written and verbal communication skills.
•           Basic to intermediate knowledge of medical terminology preferred

Essential responsibilities include, but are not limited to:
Appointment Scheduling Duties
•           Receives all incoming calls from ACD, PSR queue.
•           Determines if new or established patient, or the type of appointment.
•           Determines treating physician for described issue.
•           Obtains demographic/insurance information for new patients; verifies current insurance if established patient.
•           Creates web account and educates patient how to properly log in and utilize patient portal. 
•           Verifies eligibility and explains to new patient SCOS copay/deductible collection policy at time of service.
•           Determines if prior authorization is required (e.g., Worker’s Comp or IPA/HMO) before scheduling appointment.
•           Instructs patient to bring in x-rays, MRI/CT imaging, or any other diagnostic testing to appointment if applicable.
•           Verifies schedule for availability and advises patient of prospective dates at all available facilities.
•           Documents description of chief complaint along with pertinent medical information, noting possession of diagnostic testing/reports and any previous evaluation by another physician, as well as, insurance type and patient acknowledgement of payment collection policy.
•        Creates cases for IPA/HMOs and any Worker’s Compensation appointments with approved authorization number, number of allowed visits, referring physician and valid dates of authorization.

Other Duties

•           Responds to written and telephone inquiries from patient and carriers regarding appointments.
•           Distributes messages to the clinical staff when needed (prescription calls, testing, any clinical related questions)
•           Schedules surgeries when needed to help out department.
•           Contacts insurance carriers to verify eligibility and obtain authorization for surgeries when needed.
•           Covers for PBX operator when needed.
•           Maintains communication among the physician, patient, and insurance carriers when needed.
•           Maintains patient confidentiality; complies with HIPAA and compliance guidelines established by the practice.
•           Maintains detailed knowledge of practice management and other computer software as it relates to job functions.
•           Attends continuing education courses as requested.
•           Attends all regular staff meetings.
•           Completes all other duties as assigned by the Manager or Team Leader/Supervisor.

Supervisory Responsibilities
This job has no supervisory responsibilities.

Typical Physical Demands
•           Work may require sitting for long periods of time, and also stooping, bending and stretching for files and supplies. 
•           Employee will occasionally be asked to lift files or paper weighing up to 30 pounds. 
•           Position requires manual dexterity sufficient to operate a keyboard, operate a computer, telephone, calculator, copier, and such other office equipment as necessary. 
•           Vision must be correctable to 20/20 and hearing must be in the normal range for telephone contacts.
•           Position also requires viewing computer screens and typing for long periods of time, and working in an environment which can be very stressful.

Typical Working Conditions
•           Work involves frequent contact with patients over the telephone and sometimes in person.
•           Work may be stressful at times. 
•           Employee must be comfortable asking patients for money. 
•           Interaction with others is constant and interruptive.
Pay Range
$17.00   None to $21.00   None

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