Patient Service Representative - Women's Health

Northern Light Health•Portland, ME

2d•Onsite

About The Position

The Patient Service Representative performs daily office functions for a multi-physician hospital outpatient practice in the OB-GYN Clinic at Northern Light Mercy Hospital. The representative serves as a liaison between the practice and its patients, visitors, and guests, providing consistent, high-quality customer service. The role may involve access to confidential patient, employee, and organizational information, which must be protected according to hospital and system policies, HIPAA requirements, and ethical standards. The representative reports security events and risks, participates in relevant patient safety initiatives, and performs duties in accordance with the hospital’s mission and values. This position supports patient access and clinic operations by handling registration, scheduling, insurance verification, referrals, payments, patient communications, health information requests, and patient records. It requires collaboration with the care team, attention to workflow and productivity, and a patient-centered approach. The role is full-time, 36 hours per week, with a variable schedule, at the Mercy Medical Office Building in Portland, Maine.

Requirements

High school diploma or GED.
Ability to provide effective customer service and communicate clearly and appropriately in writing and verbally.
Ability to handle confidential information in accordance with HIPAA and organizational policies.
General understanding of insurance plans, with more detailed knowledge of frequently encountered plans.
Ability to maintain productivity and efficient workflow in a busy practice.
Ability to work collaboratively and demonstrate patient-centered care, integrity, respect, accountability, and compassion.

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 workflows while accommodating 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 promptly to the appropriate person.
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 knowledge and verification systems to assess eligibility and take appropriate action.
Obtain patient consents and signatures and schedule follow-up appointments when indicated.
Reconcile payments and appointments and complete validation at the end of the day.
Investigate insurance denials monthly to recover lost revenue and support clean claim submission.
Participate in the referral process and 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 and invite patients 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, according to practice procedures.
Provide backup for coworkers as needed.
Promote the organization’s mission and values and comply with hospital, state, and federal regulations and HIPAA standards.
Perform additional assigned duties to maintain facility efficiency and continuity.
Report security events, potential events, and other security risks.