Patient Services Representative (CC2699 - NIC)

CommuniCare•San Antonio, TX

10d

About The Position

Responsible for answering telephone calls, making appointments, providing exemplary customer service, and assisting with referrals for Family Practice, Pediatric, and Behavioral Health providers. The role assists with insurance coverage verification and obtaining authorizations when needed, enters referrals, and documents communications in the Electronic Medical Record system. It also maintains an appointment system that meets applicable professional, administrative, and legal requirements. The representative provides courteous telephone service, schedules appointments using provider templates, keeps patient information current, and coordinates with providers and support staff to optimize schedules. The role informs patients about registration and release-of-information documentation, tracks referral documentation to support patient safety, and provides information about the Sliding Fee Scale program. Calls involving immediate patient needs or complaints are directed promptly to the appropriate clinical or administrative staff. Scheduled hours and/or work locations may change.

Requirements

High school graduate or equivalent.
At least one year of customer service experience.
Basic computer skills, including proficiency in data entry and keyboarding.
Ability to use fingers for small movements such as typing or picking up small objects.
Ability to frequently convey detailed or important information accurately and clearly.
Ability to hear average or normal conversations and receive ordinary information.
Ability to perform frequent, regular repetitive movements using the wrists, hands, and fingers.
Average visual acuity necessary to prepare or inspect documents or other materials.
Ability to bend, stoop, and stand for most of the time.
Ability to lift folders, files, papers, equipment, and similar items weighing up to approximately 25 pounds.

Nice To Haves

Medical background experience preferred.
Bilingual English/Spanish preferred.

Responsibilities

Answer telephone calls promptly and courteously, following established telephone etiquette and supporting improvements to call flow and communication services.
Schedule patient appointments according to established provider templates; keep patient information current; coordinate with providers and support staff to optimize schedules; and make schedule changes as needed.
Enter accurate demographic information in NextGen EPM and relay scheduling information with healthcare companies or organizations.
Inform patients of documentation needed for registration, account updates, or release of patient information.
Track and document referrals to support patient safety.
Provide information about Sliding Fee Scale availability and the documentation required for participation.
Refer calls promptly to the appropriate clinic or clinician nurse when a patient expresses an immediate need.
Transfer complex or complaint calls to the appropriate Director, Supervisor, or Department while ensuring patient satisfaction and confidentiality.
Provide excellent internal and external customer service by telephone to assist patients with their healthcare needs.
Suggest improvements and participate in organized efforts to improve service excellence.
Perform other related duties as assigned.