Patient Reception Rep - FT - Day - Primary Care New Hope PA

Capital Health•New Hope, MN

About The Position

The Patient Reception Rep provides front-desk and clerical support for Capital Health Medical Group practices. The role handles incoming calls, routes patient inquiries, schedules appointments and outpatient tests or surgeries, prepares charts and paperwork, welcomes patients and visitors, and completes patient registration. It also supports compliance with privacy and other regulatory requirements; collects payments; processes claims, referrals, and authorizations; manages follow-up scheduling and assigned worklists; and balances daily payment batches. The employee may be assigned to other Capital Health Medical Group practices as needed.

Requirements

High school diploma or equivalent.
One year of experience as a receptionist or clerk in a healthcare environment, or one year of customer service experience.
Familiarity with medical terminology, ICD-10, and CPT codes.
Excellent communication and interpersonal skills.
Proficient computer skills and basic Microsoft Office skills.
Familiarity with Excel spreadsheets.

Nice To Haves

Medical assistant or medical office technician certification preferred.

Responsibilities

Answer telephones promptly and courteously while handling multiple phone lines, and route patient calls to the appropriate area or individual.
Schedule and cancel appointments according to office guidelines; schedule patients for outpatient tests and surgeries according to Capital Health policy.
Prepare for the day by reviewing eligibility and phone reports, completing related tasks, and preparing new-patient charts or paperwork.
Greet patients and visitors professionally; explain privacy policies and procedures; communicate physician schedule delays and assist patients while they wait.
Register patients and ensure demographic and insurance information is accurate and complete.
Comply with department procedures and regulatory guidelines for HIPAA, Advance Beneficiary Notice, Advance Directives, and Patients Rights, as assessed by quality assurance and observation.
Ensure required check-in and check-out fields are complete.
Obtain copies of insurance cards, driver's licenses, authorizations, and referrals, and scan or enter them into the system.
Collect co-payments and outstanding balances at check-in, and time-of-service and estimated balances at check-out; refer patients to CBO staff for past-due balances, questions, or resolution.
Review and comply with Patient Account Notes and Appointment Notes, and take accountability for assigned dashboard worklists and boxes.
Confirm charges and approve claim creation at check-out; validate and submit claims for real-time adjudication; work the Day End Review report and designated Tier-based HOLD Claim Worklists daily.
Schedule follow-up appointments, create appointment ticklers, and work associated assigned worklists and boxes.
Complete referrals and pre-authorizations as required.
Create a Time of Service batch, link it to a deposit batch daily, reconcile and close each batch or drawer at the end of the day, and turn batches over to the designated resource daily.
Perform clerical duties such as processing mail, confirming appointments, sending follow-up notices, and maintaining statistics.
Perform other assigned duties and work at other Capital Health Medical Group practices as needed.