AHD Ambulatory Patient Services Representative

Alameda Health System•Alameda, CA

About The Position

Under general supervision, the Patient Services Representative (PSR) provides specialized clerical support to clinic registration units and screens patients for possible eligibility for financial assistance programs. The PSR is specially trained in patient registration and less complex enrollment of eligible patients into programs including the Childhood Health and Disability Program (CHDP), AHS Charity Program, Presumptive Eligibility (PE), and Cancer Detection Program (CDP). PSRs also support the day-to-day functions of clinic practices and team-based care and may work at alternate locations as necessary. The role provides patient-centered customer service, coordinates with patients and healthcare providers, and performs registration, appointment scheduling, financial screening, payment processing, insurance verification, program enrollment, referral and authorization processing, recordkeeping, and related clinic support. The PSR uses computer applications and standard office equipment to enter and retrieve patient and billing information, prepare reports, communicate with patients and staff, and support ambulatory care services. The position also participates in outreach and quality improvement activities and serves vulnerable and underserved patients.

Requirements

High school diploma or equivalent.
Demonstrated ability to use computer and telephone systems and generally navigate application systems.

Nice To Haves

Medical terminology knowledge is preferred but not required.
Bilingual ability is preferred but not required.

Responsibilities

Provide patient-centered care that respects and responds to individual patient preferences, needs, and values, and promote excellent customer service for internal and external customers.
Collaborate with patients and healthcare providers to support coordinated, high-quality care.
Register and preregister patients for ambulatory care; interview patients to obtain billing and financial-screening information, establish sources of payment, and prepare registration packets and patient visits.
Schedule appointments in person and by phone.
Advise patients or guarantors of financial obligations; collect and process payments, co-payments, and pre-payments; verify insurance eligibility and coverage.
Explain eligibility requirements, rights, and obligations for Federal, State, and County programs; assist patients with applications and forms and review them for accuracy and completion.
Enter registration and billing information into computer applications, retrieve data, and prepare reports related to patient census, insurance, and financial status.
Distribute, complete, and collect ambulatory care forms and documents; explain available services and resources; determine enrollment options and enroll eligible patients in health coverage and financial assistance programs as needed.
Maintain records of unit productivity, patient location, registration, and discharge.
Inform medical providers of patients’ financial status and communicate with healthcare providers and staff about conditions or diagnoses that may qualify patients for assistance with healthcare costs.
Respond to inquiries about AHS healthcare services, explain AHS and Ambulatory Care Services policies and procedures, and direct patients to appropriate medical service areas.
Process referrals and required authorization and prior authorization forms with health plans or medical/provider groups as directed by the referring provider; generate correspondence and notify patients and providers of authorization determinations or barriers to scheduled services.
Conduct outreach to support AHS organizational goals and initiatives.
Operate standard office equipment and use AHS applications, including the Electronic Health Record, Financial Billing and Registration, and online resources, as well as telephone and email.
Provide backup and coverage support for Ambulatory Care Services as assigned.
Participate in performance improvement and quality control activities.
Demonstrate empathy for vulnerable populations and underserved patients.
Perform related duties as assigned.