Patient Services Representative
About The Position
The Patient Services Representative handles front-office functions in support of Ryan Health’s mission and goals. The role processes patient visits, collects payments, verifies insurance, updates patient registration, provides information about Center services, and directs patients to appropriate departments and community resources. It also processes and tracks referrals, including urgent, STAT, and high-risk referrals, and maintains related information in electronic health record systems. The position is based at Ryan Chelsea Clinton in New York, NY. It is full-time, entry-level, and on the day shift. The listed salary range is $27.96–$29.56 per hour. A 90-day probationary period applies. Work is primarily in an ambulatory primary care setting, where employees may encounter unpredictable behavior and acute or chronic contagious infectious diseases; adequate preparation and precautions are necessary.
Requirements
- Experience in a front-office healthcare environment.
- Enjoy working with the public and respect patient confidentiality.
- Working knowledge of electronic health record systems.
- Excellent communication and interpersonal skills.
- Strong customer service skills.
- High school diploma or GED.
- Professional, courteous, and respectful approach to patients; knowledge and skills appropriate to the age of patients served; and commitment to exceeding patient expectations.
- Ability to work well with others, contribute input to improve outcomes, seek opinions and feedback, and provide feedback tactfully and respectfully.
Nice To Haves
- Experience with the eClinicalWorks electronic health record system.
- Experience working in a community or human services agency.
- Bilingual English/Spanish.
Responsibilities
- Check patients in, create same-day visits when needed, and check patients out after booking appointments according to provider instructions.
- Collect copays, fees, and outstanding balances; balance collected patient revenue for bank deposit; and process applicable payment plans and bills.
- Verify insurance coverage and detailed insurance information, bill patient insurance for services, maintain insurance verification in the electronic medical record, and assist patients with insurance restrictions.
- Direct third-party and privately insured patients to the Patient Accounts Department and ensure referrals and authorizations are obtained before processing visits.
- Screen patients for sliding-fee eligibility and insurance assistance, and inform eligible patients about entitlement assistance, including Medicaid plans, accepted managed care plans, and ADAP; refer them to appropriate staff.
- Orient patients to Center services, procedures, hours, fees, scheduling and cancellations, patient rights, and the Board of Directors.
- Collect patient information and ensure it is signed and scanned into the patient hub; update or recertify registration information when needed or when patient details change.
- Assist patients with changing their primary care provider by contacting their insurance plan, and capture patient photos with appropriate equipment when authorized.
- Refer patients to appropriate Ryan Health departments and community or social agencies as needed.
- Process telephone encounters, book and status referral requests, schedule and status urgent/STAT/high-risk referrals, review practitioner schedules and mark no-shows, and verify addresses and telephone numbers for certified mail.
- Consult providers or authorized staff when a provider’s schedule must be overridden and serve as a greeter when assigned by a supervisor.
- Screen and complete insurance applications for eligible patients, process utilization thresholds, and update insurance information according to current procedures.
- Ensure specialty referral forms are initiated and complete, fax forms and supporting documents to off-site specialists, and obtain prior authorization when required by the patient’s insurer.
- Schedule off-site specialist appointments according to practitioner notes or patient preference and document appointment details and status in the patient’s EHR.
- Maintain assigned referrals according to the Network’s referral management policy and procedure; process, monitor, and reconcile urgent/STAT/high-risk referrals.
- Ensure urgent/STAT/high-risk appointments are scheduled within required timeframes, monitor attendance, obtain consultation reports, and review monthly referral reports to track timeliness metrics.
- Maintain and update incoming referrals to ensure off-site appointments are scheduled; contact patients with appointment information using their preferred contact method, and print and mail completed referral forms.
- Call patients with appointment information when the appointment is within five business days or less.
- Review billing/global alerts before processing patients and immediately report problems or unusual occurrences to a supervisor.
- Attend trainings and webinars assigned by a supervisor and perform other duties or projects as assigned.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
