Patient Services Rep II-Primary care

The Nemours Foundation•Newark, NJ

10d•Onsite

About The Position

Nemours is seeking a full-time Patient Services Representative II for its Newark Primary Care office. The role provides service excellence to patients and families by completing the business processes associated with outpatient visits. The representative prepares patients and families for appointments in a timely and efficient manner, verifies demographic and financial information before visits, and monitors the waiting room and work environment to support patient safety and high service levels. The position participates in Nemours continuous quality, performance, and service improvement programs and works with department management using a team-based approach to improve services. The representative greets and communicates with patients and families using the AIDET protocol and completes appointment preparation, check-in, visit, and check-out processes. Duties vary by outpatient location and may include appointment preparation and confirmation, authorization and referral handling, demographic and insurance verification, consent and document processing, payment collection, follow-up scheduling, MyNemours enrollment assistance, waiting-room communication, payment reconciliation, reporting, and daily work-queue completion. The role also maintains competency with relevant computer and electronic systems, keeps supplies and work areas orderly, and may provide phone coverage and route correspondence, results, and consultations in collaboration with clinical staff.

Requirements

High school diploma or equivalent.
At least 3–6 months of job-related experience.
Computer and typing skills.
Clerical experience in a physician’s office is preferred.
EPIC experience is preferred.

Nice To Haves

Clerical experience in a physician’s office.
EPIC experience.

Responsibilities

Greet and communicate with patients and families at the start of outpatient visits and during interactions using the AIDET protocol.
Complete outpatient appointment business processes before, during, and after appointments, including check-in and check-out duties.
Prepare for scheduled patient visits up to 48 hours before the appointment according to location or service protocols.
Make confirmation calls not completed by Televox and ensure visits are confirmed according to department protocol.
Confirm authorizations and collect referrals for the day’s visits; notify the Pre-Registration and Authorization Department about same-day visits as needed.
Fax hard-copy referrals to the PRAG department within 24 hours of receipt.
At check-in, verify patient demographic information, identity using two approved identifiers, legal guardianship, and referral information while maintaining confidentiality and HIPAA requirements.
Prepare, complete, or collect consents and required documents; scan insurance cards and other important documents.
Collect and post co-pays and past-due balances, and achieve registration accuracy of at least 95%.
Schedule follow-up appointments, using iGuide to determine participation when appropriate.
Support MyNemours sign-ups and facilitate account activations.
Communicate regularly with clinical staff about waiting patients, especially those waiting more than ten minutes, and provide patients and families with appointment status updates using AIDET principles.
Contact the manager about problem situations or when service recovery is necessary.
Reconcile payment collections at the end of each shift according to the Cash Collections Policy and complete End of Day reports, including DCRF and LDCRS.
Complete assigned work queues daily and maintain competency with scheduling, appointment cancellations, clinical order entry, iGuide, EOD status changes, work-queue processing, referral linking, posting other payments, scanner use, and electronic insurance verification.
Maintain clerical supply inventory and keep the work environment and outpatient waiting room orderly and clean to support patient safety and security.
Schedule and cover phones as needed or as directed, including handling automated call distribution, maintaining in-baskets related to Online Scheduling, MyNemours, and office communications, and making recall, waitlist follow-up, post-inpatient-discharge, or clinic-cancellation calls.
Collaborate with the clinical team by opening, sorting, and routing correspondence, laboratory and imaging results, procedures, and consultations to the appropriate team member for patient communication.