Patient Services Rep

San Diego American Indian Health Center•San Diego, CA

About The Position

We are an FQHC community health center dedicated to embodying the values central to American Indian cultures. This includes respect for our patients, acknowledgement of the whole person, and a focus on working together to ensure health for the individual, and therefore the community. We invite persons of all tribes, ethnic backgrounds and walks of life to experience the comprehensive care we deliver and to contribute to the services we provide for children, youth, families, adults, and elders. This position serves as the Patient Services Representative for SDAIHC. The role is integral to providing outstanding patient care by warmly welcoming patients, efficiently managing incoming calls, overseeing registration and appointment scheduling. Additionally, the representative ensures accurate insurance verification and clearly communicates financial responsibilities to patients. The position is also responsible for updating patient information, required administrative forms, and documentation in both the eCW and Electronic Health Records (EHR). In addition to these core duties, this role includes performing a variety of clerical tasks to support the smooth operation of the medical department. The PSR plays a critical role in ensuring timely patient access to care by maintaining a call abandonment rate below 7%, scheduling appointments accurately within department protocols, and verifying complete and correct patient demographic information at every encounter. In addition to these core duties, this role includes performing a variety of clerical tasks to support the smooth operation of the medical department. Must be able to demonstrate knowledge and skills necessary to perform all job-related activities as outlined below.

Requirements

High School Diploma or GED (equivalent).
2-3 years related experience and/or training, or equivalent combination of education and experience.
Strong oral and written communication skills.
Exceptional time management skills
Highly organized and attention to detail.
Capable of maintaining confidentiality and accurate record-keeping.
Strong interpersonal skills.
Ability to interact effectively with diverse individuals.
Demonstrates the ability to establish and sustain cooperative working relationships throughout the course of work.
Competence in performing basic mathematical calculations is necessary for job responsibilities.
Dependable and highly trustworthy.
Proficiency in Microsoft office suite or similar software programs.
CPR/ BLS certification: Maintain a current Basic Life Support (BLS) certification issued by the American Heart Association (AHA), the American Red Cross, or an equivalent organization. Certification must include an in-person, hands-on skills assessment. Online-only certifications are not accepted.
Annual background checks: Consent to annual background checks as a condition of continued employment, to ensure compliance with organizational standards and eligibility requirements.
For-Cause Drug Screening: Comply with drug screening requirements when initiated by the organization for cause, to support a safe, compliant, and drug-free workplace.
Ongoing Compliance Requirements: Maintain up-to-date compliance with all required annual renewals, including professional licenses, certifications, physical examinations, TB testing, and mandatory regulatory trainings as assigned by the San Diego American Indian Health Center (SDAIHC).

Nice To Haves

Experience serving a multinational, multicultural population.
FQHC background.
Familiarity with Community Health Clinics and/or Indian Health Clinics.
ECW EHR.

Responsibilities

Warmly greet patients in a courteous and respectful manner while maintaining a clean, safe and comfortable reception area and patient lobby.
Process new patient registration in accordance with billing and medical records guidelines.
Ensures accurate verification and data entry of patient demographics insurance information, and scanning required clinical and a and administrative forms, screening and processing of applications for medical programs CHDP/EWW/FPACT/SFS/RHAP) and correct entry of clinical codes during check in.
Gather patient information for walk in triage by completing a triage slip (including patient’s name, HRN #, DOB, chief complaint, payer source), verify insurance eligibility and benefits, and collects necessary administrative and clinical forms following medical department procedures.
Collects payments for outstanding balances, co-pays, and services provided at the time of service and provides patients and the fiscal department with accurate receipts in accordance with fiscal guidelines.
Makes next patient appointments in accordance with medical scheduling templates and scheduling guidelines established by the Medical Director.
Answers incoming calls and ensure new patient appointments, appointment cancellations and rescheduling of appointments are completed in a timely manner. Ensure voicemail messages and return phone calls are completed promptly by front desk process and guidelines.
Maintains schedules updated with status throughout the business day, assures no-shows are coded and patients are checked-in and out in a timely manner in accordance with medical department guidelines and process.
Performs “end of day” duties: Double checks receipts, cash reconciliation, and all manual work.
Ensure front desk forms and front office supplies are fully stocked for the next business day.
This position may require rotating coverage across the Behavioral Health, Dental and Medical front desk.
Identifies patient payer sources, verifies insurance eligibility, and benefits and determines co-pays and deductibles, PCP changes needed, SFS notifications, and communicates to patients and front desk prior to appointment.
Ensure scheduled appointments are scheduled within scheduling guidelines, PCP assignments are accurate, forwards HEDIS insurance print outs to medical staff and communicates any discrepancies to immediate supervisor and provider.
Completes administrative check offs by reviewing patient EHR, scheduling system (ECW) and identifies outstanding required administrative and clinical forms, administrative required documents such as native verifications, photo IDs, insurance cards and completion of SFS applications. Request paper chart from medical records as needed in accordance with medical records policy and guidelines.
Ensures data entry of payer source is accurate and updated to coincide with insurance verification, sequence patient’s payer sources on the date of service in accordance with billing guidelines.
Scans all insurance verification to EHR, edits creation date, and double checks for readability and accuracy.
Ensure the medical schedules remain booked by calling patients from the “waiting list”.
Other duties as assigned.