Patient Service Representative (Clerk III)

Commence•Virginia Beach, VA

5d•$20 - $25•Onsite

About The Position

The Patient Service Representative (Clerk III) ensures that beneficiaries are informed, updated, and assisted when necessary. The position responds to beneficiary questions, triages beneficiary calls, performs case intake, and staffs the Medicare Helpline as required. The representative informs Medicare beneficiaries and other interested parties about patient rights and responsibilities under Medicare, serves as a neutral liaison for beneficiaries and their families or representatives, and explains the activities and responsibilities of the Quality Improvement Organization (QIO) to beneficiaries, healthcare providers, and other partners. The role supports timely and accurate review processes, builds relationships with customers, prepares correspondence, maintains contact information and mailing lists, processes medical records, and records calls, conversations, and correspondence in an electronic web-based application. The position also enters data accurately and promptly, participates in continuous improvement, assists with ISO audit preparation, and protects beneficiary information in accordance with HIPAA and HITECH. The representative attends required annual security awareness, rules of conduct, and conflict of interest training, and performs other duties as assigned. This is an in-office position in a climate-controlled environment. Employees regularly sit, read, work on a computer, and watch a computer screen for extended periods, and may occasionally stand, walk, use their hands and fingers, kneel, or crouch. Schedules vary and include weekend and holiday shifts.

Requirements

Experience as a call center representative or patient service representative.
Considerable knowledge of business English, medical terminology, spelling, punctuation, vocabulary, filing, and general office methods.
Working knowledge of healthcare provider businesses and the components of medical record documentation.
Knowledge of CMS, Medicare, and BFCC-QIO programs.
Meet one of the following education and experience paths: an associate degree in business education or health information management and two years of experience related to a majority of the primary duties; graduation from a secretarial school and three years of related experience; or a high school diploma or GED and four years of experience related to most primary duties.
Two years of experience and skill in Microsoft Word and Microsoft Excel spreadsheet programs.
Excellent oral and written communication skills.
Attention to detail.
Familiarity with database software programs, such as Microsoft Office.
Excellent interpersonal and problem-solving skills.
Ability to exercise sound judgment, organize and coordinate multiple simultaneous tasks in a team environment, and work independently.
Ability to maintain effective working relationships and communication with providers and stakeholders.
Ability to collect data and distinguish relevant material, maintain objectivity, and give and receive feedback.
Ability to work well with other patient service representatives and team members and maintain professional relationships with people at all levels, physicians, and others outside the company.
Ability to meet the physical demands of the role, including prolonged sitting, reading, computer work, and viewing a computer screen, with occasional standing, walking, hand and finger use, kneeling, or crouching.
Must be able to work schedules that vary and include weekend and holiday shifts.

Responsibilities

Inform Medicare beneficiaries and other interested parties of their rights and responsibilities as patients covered by Medicare.
Assist with review processes to maintain required timeliness and accuracy under the contract and the QIO manual.
Act as a neutral liaison for beneficiaries, their families, or their representatives.
Inform Medicare beneficiaries, healthcare providers, and other partners about QIO activities and responsibilities.
Develop and maintain positive relationships with internal and external customers.
Prepare correspondence to physicians, facilities, and other healthcare and community organizations as needed.
Verify current and correct contact information, maintain mailing lists, and coordinate mailings.
Process and maintain medical records.
Track telephone calls, essential conversations, and letters mailed to beneficiaries and providers using an electronic web-based application.
Enter data into software applications accurately and in a timely manner.
Participate in continuous improvement by identifying quality issues and recommending solutions.
Assist with preparation for International Standardization Organization (ISO) audits.
Protect beneficiary information in compliance with HIPAA and HITECH.
Attend annual security awareness, rules of conduct, and conflict of interest training.
Perform other duties as assigned.
Respond to beneficiary questions, triage calls, perform case intake, and staff the Medicare Helpline as required.