Lead Patient Support Representative

Appalachian Mountain Community Health Centers•Murphy, NC

4d•$17 - $22

About The Position

Summary of Responsibilities Responsible for guiding the front office team to ensure positive business outcomes. Duties include focusing on the constant improvement and maintenance of customer service, process efficiency and effectiveness, lowering error rates, improving TOS payments, and establishing and maintaining daily protocols. Key Accountabilities Coordinate and manage the activities of front office team members engaged in checking in patients and performing general administrative tasks as directed. Monitor daily performance of front office team members ensuring that all check-in protocols are followed by every team member all the time, ensuring patient ID, all demographics are updated and insurance cards are asked for at every visit and entered correctly. The only acceptable goal is 100% verification of all insurances and coverage prior to the patient setting foot in the practice and is entered correctly in the system. Hold daily huddles to assist with prepping for the next day schedule by looking at patient’s accounts for balances, copays, problems with insurance and demographics. Ensure co-pays and any balances due are paid at TOS while checking the patient in, and providing patients with a receipt of payment. If no copay is received a “Billing Alert” comment needs to be added as to why. Notify the billing department regarding patients who have outstanding balances, financial questions, questions regarding their account, and questions about payment plans. Prepare payment plans for patients at time of service and notify billing department. Monitor Family Planning Medicaid and ensure the waiver is being signed at every visit if it is not related to family planning. Meets reasonable benchmarks set by Revenue Cycle Manager regarding the error rate found with patient demographics and insurance. Meet with the Revenue Cycle Manager monthly and relay pertinent information to front office team members timely. Checking patients in and out, which includes collecting and entering or verifying patient demographic information such as insurance and/or sliding fee discounts at each appointment Scanning and organizing patient documents in the Practice Management (PM) system or Electronic Health Record (EHR) as appropriate Assessing patient eligibility for the sliding fee discount program (SFDP) and clearly communicating responsibilities of the patient as part of the SFDP (e.g. providing documentation of income) Assessing charges, including past due balances and collection of fees (e.g. co-payment, co-insurance, point-of-care incentive) Referring patients with questions regarding billing statements to AMH’s revenue cycle vendor Assessing accuracy and completeness of medical record requests from patients, providers and third parties, scanning requests into the EHR and assigning requests to AMH’s medical records vendor Providing AMH organizational information such as location of practices, hours of operation, insurance participation and SFDP to patients, providers and third parties Actively participating in and supporting quality improvement practices. Maintaining confidentiality and complying with all aspects of the Health Insurance Portability and Accountability Act (HIPAA) Making reminder calls for next-day appointments and informing patients to bring any necessary items, including photo identification, co-payment and current medications Assisting clinical staff with patient referrals for specialty care As appropriate based on skill set, providing language interpretation to patients appropriate to the front desk role and translating written and web-based documents As appropriate based on education and skill set, assisting the clinical team as a Medical Assistant.

Requirements

High School Diploma or GED required.
At least two years of experience in a primary care or public health setting functioning at the full extent of her/his training
Experience with Practice Management systems and HER

Nice To Haves

Experience working with racially and ethnically diverse populations, low-income populations and people experiencing homelessness
At least two years of experience in a primary care or public health setting functioning at the full extent of her/his training
Experience with Practice Management systems and EHR

Responsibilities

Coordinate and manage the activities of front office team members engaged in checking in patients and performing general administrative tasks as directed.
Monitor daily performance of front office team members ensuring that all check-in protocols are followed by every team member all the time, ensuring patient ID, all demographics are updated and insurance cards are asked for at every visit and entered correctly.
Hold daily huddles to assist with prepping for the next day schedule by looking at patient’s accounts for balances, copays, problems with insurance and demographics.
Ensure co-pays and any balances due are paid at TOS while checking the patient in, and providing patients with a receipt of payment.
Notify the billing department regarding patients who have outstanding balances, financial questions, questions regarding their account, and questions about payment plans.
Prepare payment plans for patients at time of service and notify billing department.
Monitor Family Planning Medicaid and ensure the waiver is being signed at every visit if it is not related to family planning.
Meets reasonable benchmarks set by Revenue Cycle Manager regarding the error rate found with patient demographics and insurance.
Meet with the Revenue Cycle Manager monthly and relay pertinent information to front office team members timely.
Checking patients in and out, which includes collecting and entering or verifying patient demographic information such as insurance and/or sliding fee discounts at each appointment
Scanning and organizing patient documents in the Practice Management (PM) system or Electronic Health Record (EHR) as appropriate
Assessing patient eligibility for the sliding fee discount program (SFDP) and clearly communicating responsibilities of the patient as part of the SFDP (e.g. providing documentation of income)
Assessing charges, including past due balances and collection of fees (e.g. co-payment, co-insurance, point-of-care incentive)
Referring patients with questions regarding billing statements to AMH’s revenue cycle vendor
Assessing accuracy and completeness of medical record requests from patients, providers and third parties, scanning requests into the EHR and assigning requests to AMH’s medical records vendor
Providing AMH organizational information such as location of practices, hours of operation, insurance participation and SFDP to patients, providers and third parties
Actively participating in and supporting quality improvement practices.
Maintaining confidentiality and complying with all aspects of the Health Insurance Portability and Accountability Act (HIPAA)
Making reminder calls for next-day appointments and informing patients to bring any necessary items, including photo identification, co-payment and current medications
Assisting clinical staff with patient referrals for specialty care
As appropriate based on skill set, providing language interpretation to patients appropriate to the front desk role and translating written and web-based documents
As appropriate based on education and skill set, assisting the clinical team as a Medical Assistant.