Patient Service Representative - Physical Rehab

Northern Light Health•Portland, ME

12d•Onsite

About The Position

The Patient Service Representative performs daily office functions for a multi-physician hospital outpatient practice in Physical Rehab Services at Northern Light Mercy Hospital. The role serves as a liaison between the practice and its patients, visitors, and guests, consistently providing a high level of customer service. The representative handles confidential patient, employee, and organizational information in accordance with hospital and system policies, HIPAA requirements, and ethical standards; reports security events and risks; participates in relevant patient safety initiatives; and performs responsibilities in accordance with the hospital’s mission and values. The position supports patient registration, appointment scheduling, insurance verification and referrals, payment collection, records requests, and day-to-day practice operations. It requires effective communication with patients and coworkers, attention to accuracy and confidentiality, and a cooperative approach to improving workflows and patient outcomes.

Requirements

High school diploma or GED.
Ability to provide polite, prompt, and helpful customer service.
Ability to maintain productivity and efficient workflow in a busy practice.
Ability to handle difficult conversations with patients and internal customers.
Ability to accurately handle patient demographics, insurance information, payments, appointments, and confidential health information.
Ability to follow insurance, referral, patient safety, organizational, and HIPAA policies.

Responsibilities

Treat patients and customers politely, promptly, and helpfully in keeping with organizational values and standards.
Participate in regular huddles and team meetings to improve workflows and patient population outcomes.
Maintain productivity and efficient workflow in response to the practice’s volume and acuity.
Handle difficult conversations with patients and internal customers.
Accurately register patient demographic and insurance information and provide required forms in accordance with insurance regulations and practice policy.
Respond to incoming inquiries, screen calls, document detailed messages, and route them to the appropriate person in a timely manner.
Schedule, reschedule, confirm, acknowledge, and cancel patient appointments, including surgical and ancillary service appointments.
Monitor daily schedules and notify the manager or team members of potential issues or access opportunities.
Collect copayments and patient balances due.
Use insurance verification systems and take appropriate action based on eligibility responses; maintain general understanding of insurance plans and more detailed knowledge of frequently seen plans.
Obtain patient consents and signatures and schedule follow-up appointments when indicated.
Reconcile payments and appointments and perform validation at the end of the day.
Investigate and problem-solve insurance denials monthly to recover lost revenue and support submission of clean claims.
Make patient-centric decisions and participate in the referral process according to Medical Associates protocols.
Initiate, receive, or process insurance and service referrals in compliance with the patient’s plan and referral protocols.
Identify, report, and participate in resolving potential or actual patient safety issues.
Process health information requests in accordance with organizational and Medical Associates policies.
Screen patients and invite them to use the electronic patient portal.
Interact cooperatively and positively with others to promote a team environment.
Create, maintain, and retrieve patient charts, physically or electronically, as outlined by the practice.
Back up coworkers as needed and perform additional duties to maintain facility efficiency and continuity.
Promote the organization’s mission and values and comply with hospital, state, and federal regulations, including HIPAA.
Report security events, potential events, and other security risks.