Lead Patient Services Representative

Wellstar Health System

17h • Onsite

About The Position

This role functions in a working supervisory capacity, overseeing front office Patient Service Representatives (PSRs) and focusing on customer service and daily operations. The Lead PSR will support the training and development of PSRs, provide customer service and service recovery, conduct audits for quality and compliance, and collaborate with the clinic supervisor for planning and goal setting. The Lead will be cross-trained in all functions to ensure smooth department operations. Local travel may be required. This position serves as a liaison between patients and physicians, supervising PSR staff in facilitating patient visits and appointment scheduling. Responsibilities include handling appointment scheduling, answering phones, cashiering, and patient check-in/check-out, ensuring a positive patient experience. The Lead PSR oversees PSR functions related to obtaining demographic, financial, and insurance information for billing and collections, and conducts screening for pre-certification and eligibility for Medicare, Medicaid, and managed care patients. They obtain necessary consents, maintain knowledge of insurance benefits, coordinate collection of patient liabilities, and respond to customer inquiries. The role involves using computers to access/update records, performing advanced clerical functions such as new patient registration, taking meeting minutes, conducting front office huddles, data entry, managing office supplies, ordering supplies, and working within the EPIC system. They verify and post transactions, process receipts, sort and file documents, provide hospital information, and refer patients to financial counselors. The Lead PSR acts as an extended resource to the Clinical Supervisor, executing day-to-day workflows in agreement with the supervisor, with the majority of their work focused on PSR duties and front desk efficiency.

Requirements

• High School diploma or GED Required
• Minimum 2-4 years of related experience, in a healthcare or institutional work setting.
• Previous employment record that reflects work stability, as indicated by an average work tenure for previous jobs of at least one (1) year.
• Typing or data entry competency of at least 30-40wpm accurately
• Ability to work independently yet operate as an integral part of a team
• Intermediate computer skills
• Experience with multi-line phone system
• Insurance and medical terminology as well as pre-certification/authorization process preferred
• Working knowledge of use of routine office equipment
• Ability to independently organize and prioritize workflow
• Demonstrated professionalism and ability to handle pressure situations while maintaining tact and diplomacy, excellent verbal and written communication skills, and active listening.

Nice To Haves

• Insurance and medical terminology as well as pre-certification/authorization process

Responsibilities

• Functions in a working supervisory position overseeing front office Patient Service Reps focusing on customer service and day to day operations of the front office area.
• Understanding and supporting training and development of all Patient Service Reps.
• Providing customer service support and service recovery when needed.
• Overview through audits of quality and compliance of all functions completed by Patient Service Reps.
• Support the clinic supervisor through collaboration for planning and goal setting.
• Cross-trained in all functions to ensure the smooth operation of the Department.
• Serves as a liaison between patients and physicians both by telephone and in person.
• Provides supervision of all PSR staff in the duties of facilitating patient visits and appointment scheduling for clinicians within the department.
• Handle appointment scheduling, answering incoming phone calls, cashiering, and patient check-in and check-out in a courteous and efficient manner.
• Oversees the PSR functions of and participates in interviewing patients and/or their representatives to obtain complete and accurate demographic, financial and insurance information, required for billing and collecting patient accounts.
• Conducts intensive screening of all Medicare, Medicaid and managed care patients for pre-certification requirements and provider service eligibility, prior to registration.
• Obtains all necessary customer consents/attestations.
• Maintains a working knowledge of insurance benefits and coverage verification.
• Coordinates the collection of estimated patient liabilities, including co-payments.
• Responds to customer requests and answers questions regarding various service and account information.
• Analyzes and rectifies customer concerns using established procedures.
• Uses computer to access and/or update customer records.
• Must be advanced in multiple clerical functions, including registration of new patients, completing new patient paperwork, taking minutes in staff meetings, and performing front office huddles, maintaining and entering data into spreadsheets, maintaining inventory of clerical/office supplies, ordering supplies in Lawson and working in the EPIC computer system.
• Verifies and posts transactions.
• Follows established procedures for processing receipts, cash, etc.
• Sorts and files various documents.
• Assists with general hospital information and directions to departments within and outside the WellStar facility.
• Refers patients to financial counselor to establish financial arrangements to reduce financial risk for WellStar, helping to ensure that WellStar is reimbursed for its services.
• In conjunction with assigned position, the Lead PSR is assigned to act as an extended resource to the Clinical Supervisor.
• Possesses knowledge of their responsible area and must be able to execute on day-to-day workflows in agreement of the Clinic Supervisor.
• Demonstrates and reinforces presentation of a professional demeanor during interactions with all customers, co-workers and management.
• Functions as a successful core-trainer and super user of EHR, with the ability to communicate with EHR technical support to make recommendations on improvements or streamline processes with regard to EHR.
• Communicates with all levels of clinical staff and providers regarding use of EHR, department specific skills, orders, medications, referrals, documentation, and short-cuts.
• Receives requests for appointments from physicians offices and makes the necessary pre-admission arrangements, referring to lists of dates allotted for scheduling, and advising physicians office staff and patients of available dates.
• Oversees that all PSRs greet all guests with a positive and professional attitude, as well as the Lead PSR.
• Arranges to have patients escorted to procedure areas and/or assigned rooms.
• Maintains confidentiality of patient information in accordance with WellStar policy and HIPAA regulations.
• Presents a well-groomed and professional image.
• Answers incoming phone calls and routes to appropriate parties or addresses issues as directed.
• Assists physicians (and their office staff) as well as patients to expedite scheduling, pre-registration, pre-certification and/or prior authorizations.
• Maintains courteous and cooperative working relationships with patients/families, co-workers, management, physicians, other professionals, and the general public.
• Demonstrates the ability to tactfully handle difficult situations and provide service recovery.
• Ability to support any job duty at the front, while understanding the importance of managing up and collaborating with clinic supervisor when needed.
• Understands and supports WellStar HR policies and Departmental Policies with empathy and compassion for all staff by building and maintaining trust through honesty and transparency in relationship building.
• First-line problem solving skills with the ability to actively listen, understand, and solve or escalate provider or patient issues before they become more serious.
• Ability to always demonstrate the highest level of performance and behavior standards.
• Ability to be a team player through supporting and helping learn from the team and by providing performance feedback in real time.
• Keep an open mind to feedback and earn trust of staff and providers.
• Possess a positive winning attitude.
• Able to welcome challenges and view problems as opportunities.
• View mistakes as learning experiences, while believing that your efforts will make a positive difference.
• Ability to make it happen.
• Strive to meet personal, organizational, and strategic goals.
• Monitor registration processes and daily clinic operations: Ensures that the appropriate team members are immediately acknowledging and greeting patients upon arrival verbally and or nonverbally if on the phone, and that patients are checked in to the Clinic in a warm amp; friendly, organized, and efficient manner.
• Interviews each patient or representative to obtain complete and accurate demographic, financial and insurance information as well as accurately enter all patient information into the registration system.
• Reads physicians orders to determine services requested and to assure order validity.
• Obtains new medical record numbers for all new patients.
• Obtains all necessary signatures and is knowledgeable regarding any special forms that may be required by patients third-party payor.
• Documents thorough explanatory notes on patient accounts, concerning any non-routine circumstances clarifying special billing processes.
• Re-verifies all information at time of registration process.
• Understands and applies WellStar philosophy and objectives and Rehab and PAS policies and procedures, as related to assigned duties.
• Understands the outpatient and registration processes.
• Maintains a working knowledge of the process to verify insurance coverage and benefits.
• Perform and ensure that PSR staff answer incoming phone calls.
• Transfer call to appropriate department utilizing voice mail when appropriate.
• Take messages that are accurate, legible, and complete with names, dates, time, phone number, correctly routed to appropriate person.
• Complete messages and have available for pick-up within 15 minutes of call.
• Monitor phone cancellations, and update provider schedules with cancellations, communicate to clinical staff.
• Reinforces completion of all revenue collection efforts according to WellStar and PAS policies.
• Contacts patients prior to initial visit to discuss co-pay and/or self-pay arrangements.
• Collects the estimated amount at each visit and provides a receipt to the patient.
• Balances collection log and receipts at end of each business day.
• Explains prompt payment discount policies to self-pay patients.
• Routes self-pay patients to financial counselor for financial arrangements of self-pay balances, as indicated.
• Makes corrections and updates patient account information in computer as necessary.
• Documents concise and understandable notes regarding self-pay and co-pay collection activity as indicated.
• Investigates missing charges as needed.
• Collect, reconcile, and balance cash receipts each day.
• Review provider hospital billing information for completeness and forward to billing services.
• Perform proper distribution of forms and other documents to billing services.
• Participates and oversees PSR accuracy and efficiency within designated time frame to ensure a continuity of information and patient flow of the following functions: Prepares charts for therapists in a timely manner.
• Consistently demonstrates the ability to organize work, recognize and establish appropriate work priorities, and complete work in a productive manner, without creating backlogs.
• Maintains proficiency in data entry skills.
• Maintains working knowledge of all updates sent through email, All Staff PSR Meetings, or new roll out of training due to process changes.
• Incorporates ways to ensure all PSRs know process changes and/or the resources of where to find information.
• Faxes, mails, or otherwise provides medical information to referring physicians in a timely manner, as per departmental process.
• Provides copies of medical records to payers as requested for review of claims, as per departmental process.
• Effectively utilizes and daily maintains all office equipment, phone system and intercom system and PC.
• Audits tracking of financial/clinical statistical data as per departmental requirements, and functions in a clerical lead role for department.
• Work and audit EPIC work queues and logs/reports daily per demands.
• Manages up to collaborate with clinic supervisor, if improvement is needed and establish a action plan.
• Prepares and maintains accurate statistics consisting of visits, new patients, procedures, revenue, patient satisfaction, etc. for the department.
• Submits daily, weekly and/or monthly reports of statistical information to Rehabilitation administration.
• Utilizes Lawson or other method appropriately to maintain departmental ordering/inventory process.
• Provides secretarial support to supervisor/manager and clinical staff in a timely manner, maintaining appropriate confidentiality.
• Records and maintains minutes of monthly minutes of monthly departmental meetings.
• Maintains educational records for department, including entering educational information into Kronos Timekeeper.
• Perform Kronos timekeeping as instructed by clinic supervisor.
• Creates charts, forms, reports, and other documents on PC.

Benefits

• Wellstar is proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives.
• Join us and discover the support to do more meaningful work—and enjoy a more rewarding life.
• Connect with the most integrated health system in Georgia, and start a future that gives you more.
• Nationally ranked and locally recognized for our high-quality care and inclusive culture, Wellstar is one of Georgia’s largest and most integrated healthcare systems.
• Every day, 24,000+ of us work together to provide personalized care for patients at every age and stage of life – and our team members are the foundation of that care.
• At a time when the healthcare industry is changing rapidly, Wellstar remains committed to exceeding patients’ and team members’ expectations, while transforming healthcare delivery.
• Wellstar consistently receives attention and accolades from national organizations that set the standards for world-class care.
• Our system-wide practice of safety principles, assessing and addressing errors and seeking feedback from our patients and customers continually earns recognition for advances in safety and quality.
• Featured on the FORTUNE “100 Best Companies to Work For” list and Seramount 100 Best Companies list, we not only provide top-notch care for our patients, but also foster the culture of Wellstar as a Great Place to Work.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees