Patient Services Representative - Hilborn Occupational Health (Per Diem, Day)

NorthBay Healthcare Corporation•Fairfield, CA

1d•$30 - $36•Onsite

About The Position

At NorthBay Health, the Patient Services Representative (PSR) performs a combination of duties encompassing reception, appointment scheduling, authorization, registration, referrals and medical record management. Adheres to system policies related to confidentiality. The PSR functions as part of a clerical and customer service team in support of the clinic practice. PRIMARY JOB DUTIES Greets patients and/or visitors. Monitors and reviews provider(s) schedules to ensure appointments are booked with appropriate appointment type, and for correct time allocation in accordance with department scheduling policies and procedures. Answers phones and manages phone calls to determine caller’s needs. Takes appropriate messages. Directs phone call and/or message to appropriate provider, supervisory personnel, or other department staff. Places confirmation or rescheduling calls. Updates and verifies demographic and insurance/payer information and ensures accurate entry in to the system for new and existing patients. Utilizes this information during the registration process. At the end of the visit, ensures the patient has appropriate paperwork and follow up appointment as needed. Collects co-payments and, if required, share of cost, deductibles and fees, documenting information in system, as appropriate. Communicates patient financial liability to the patient. Maintains and reconciles cash journal on a daily basis. Processes cash flow per policy. Initiates the pre-registration process to determine insurance type, authorization and eligibility process as appropriate. Ensures timely management of department billing and charge processes prior to scheduling patients. Aware of third party payer restraints, coverage and treatment allocation. Assists in processing appropriate forms required for billing (e.g. TAR, Medicare forms, Workers Comp forms). Verifies and documents eligibility and benefits for all payers including identifying and resolving all managed care and third party requirements prior to first visit. Utilizes telephone and Internet eligibility sources appropriately. Informs and updates patient of authorization status as appropriate. Initiates, completes and documents authorization process for all requests for initial and recurring visits. Contacts appropriate resource to obtain authorization. Copies/scans insurance card and other required paperwork for chart, Business Office, and Physician Billing Service, as appropriate Obtains signatures on all required registration forms. Examples include but are not limited to: consent to treat, financial agreement and payer specific documents. Researches and answers inquiries related to referrals, authorization and eligibility, charges, Explanation of Benefits and denied claims. Pulls and prepares medical record in preparation for patient appointments. Assures all required documents and forms are available. Files loose documents appropriately and in a timely manner. Follows process for medical record storage and retrieval. Opens and distributes mail. Performs assigned clerical duties including but not limited to faxing, filing, copying, mail, and chart preparation. Adheres to system policies related to confidentiality. Communicates and collaborates with other departments to provide continuity of care across departments and disciplines. Consistently demonstrates and promotes a sense of team within the immediate and extended work groups, and maintains effective communication with all external and internal customers. Adheres to corporate and department specific policies and procedures. Informs and/or updates supervisory personnel of any patient concerns. Demonstrates awareness related to cost-effectiveness when using and ordering office supplies. Assists with orientation and training of new staff members/students as requested. Floats to other ambulatory clinics as assigned to support distribution of staff and patients. Actively participates in committees, in-services, staff meetings, Performance Improvement (PI) activities, and standards development. Presents a professional demeanor in appearance and attitude. Performs other duties as assigned. At NorthBay Health, our vision is to be the trusted healthcare partner of choice for the communities we serve. We are dedicated to improving the well-being of our community by providing accessible, high-quality care to all who need it. Every member of our team plays a vital role in delivering compassionate and effective healthcare solutions. We invite you to join us in our mission to ensure that every patient and family member feels valued, respected, and cared for throughout their healthcare journey.

Requirements

High school graduate or GED preferred.
Current AHA or equivalent BLS certification required .
Experience with at least two of the following strongly preferred: appointment scheduling, medical record processes, referral and authorization processes, registration processes.
Minimum of one year’s experience in a medical front office setting with experience and knowledge of health insurance/ benefit requirements preferred.
Demonstrated experience in area of clinical department.
Strong organizational and written/spoken communication skills essential.
Ability to work independently on a variety of complex tasks, managing competing deadlines.
Demonstrated working knowledge of Windows and Microsoft Word.
Detail oriented with typing and computer entry ability and a working knowledge of general office machines required.
Demonstrates the True North values. The True North values are a set of value-based behaviors that are to be consistently demonstrated and role modeled by all employees that work at NorthBay Health. The True North values principles consist of Nurture/Care, Own It, Respect Relationships, Build Trust and Hardwire Excellence.

Nice To Haves

Knowledge of medical terminology, and insurance rules and regulations preferred.

Responsibilities

Greets patients and/or visitors.
Monitors and reviews provider(s) schedules to ensure appointments are booked with appropriate appointment type, and for correct time allocation in accordance with department scheduling policies and procedures.
Answers phones and manages phone calls to determine caller’s needs.
Takes appropriate messages.
Directs phone call and/or message to appropriate provider, supervisory personnel, or other department staff.
Places confirmation or rescheduling calls.
Updates and verifies demographic and insurance/payer information and ensures accurate entry in to the system for new and existing patients.
Utilizes this information during the registration process.
At the end of the visit, ensures the patient has appropriate paperwork and follow up appointment as needed.
Collects co-payments and, if required, share of cost, deductibles and fees, documenting information in system, as appropriate.
Communicates patient financial liability to the patient.
Maintains and reconciles cash journal on a daily basis.
Processes cash flow per policy.
Initiates the pre-registration process to determine insurance type, authorization and eligibility process as appropriate.
Ensures timely management of department billing and charge processes prior to scheduling patients.
Aware of third party payer restraints, coverage and treatment allocation.
Assists in processing appropriate forms required for billing (e.g. TAR, Medicare forms, Workers Comp forms).
Verifies and documents eligibility and benefits for all payers including identifying and resolving all managed care and third party requirements prior to first visit.
Utilizes telephone and Internet eligibility sources appropriately.
Informs and updates patient of authorization status as appropriate.
Initiates, completes and documents authorization process for all requests for initial and recurring visits.
Contacts appropriate resource to obtain authorization.
Copies/scans insurance card and other required paperwork for chart, Business Office, and Physician Billing Service, as appropriate
Obtains signatures on all required registration forms. Examples include but are not limited to: consent to treat, financial agreement and payer specific documents.
Researches and answers inquiries related to referrals, authorization and eligibility, charges, Explanation of Benefits and denied claims.
Pulls and prepares medical record in preparation for patient appointments.
Assures all required documents and forms are available.
Files loose documents appropriately and in a timely manner.
Follows process for medical record storage and retrieval.
Opens and distributes mail.
Performs assigned clerical duties including but not limited to faxing, filing, copying, mail, and chart preparation.
Adheres to system policies related to confidentiality.
Communicates and collaborates with other departments to provide continuity of care across departments and disciplines.
Consistently demonstrates and promotes a sense of team within the immediate and extended work groups, and maintains effective communication with all external and internal customers.
Adheres to corporate and department specific policies and procedures.
Informs and/or updates supervisory personnel of any patient concerns.
Demonstrates awareness related to cost-effectiveness when using and ordering office supplies.
Assists with orientation and training of new staff members/students as requested.
Floats to other ambulatory clinics as assigned to support distribution of staff and patients.
Actively participates in committees, in-services, staff meetings, Performance Improvement (PI) activities, and standards development.
Presents a professional demeanor in appearance and attitude.
Performs other duties as assigned.