Patient Services Representative (CC2681 - NIC)

CommuniCare

Posted 3 months ago

Full Time

San Antonio, Texas

In Person

Smart Summary

Responsibilities

Responsible for managing patient appointments, handling telephone inquiries, and providing high-quality customer service. The role involves processing referrals, verifying insurance coverage, and documenting communications within the Electronic Medical Record system.

Qualifications

You have a high school diploma or equivalent and at least one year of customer service experience. You possess basic computer skills with proficiency in data entry and keyboarding. A medical background and bilingual English/Spanish skills are preferred for this role.

Must Have Skills for ATS

NextGen EPM

data entry

keyboarding skills

Job Description

Responsible for answering telephone, making appointments, providing exemplary customer service. Assist with completion of referrals for Family Practice, Pediatric and Behavioral Health providers. Assist with verification of insurance coverage and obtain authorizations if needed. Enters referral and documents communications in Electronic Medical Record system. Maintains appointment system adequate to meet applicable professional, administrative and legal requirements.

DUTIES AND RESPONSIBILITIES:

  1. Provides appropriate telephone etiquette established by providing prompt and courteous service upon each telephone call received. Seeks and supports changes in call flow processes and communication services. Suggests improvements and participates in organized efforts to improve service excellence levels. 
  2. Schedules patient appointments by abiding by the established provider template ensuring the patient information is current and/or updated. Works cohesively and interdepartmentally with providers and support staff to optimize the provider’s schedule and performs patient schedule changes as needed. Schedules and relays information with company or organization in healthcare field. Ensure accurate demographic information is entered in NextGen EPM. 
  3. Informs patients of required documentation necessary for registration, account update or release of patient information. Ensures ongoing tracking provides appropriate documentation on referrals to promote and ensure patient safety. Provides required information to patients of Sliding Fee Scale availability and the required documentation required for program participation. 
  4. Refers patient telephone calls promptly to the appropriate clinic or clinician nurse if patient voices an immediate need.  
  5. Transfers complex and/or patient complaint telephone calls to the appropriate Director/Supervisor/Department to ensure patient satisfaction and confidentiality.  
  6. Provides excellent internal/external customer service via telephone contact to assist patients with their health care needs.  
  7. Performs other related duties as assigned. 

JOB QUALIFICATIONS:

High School graduate or equivalent required

Medical background experience preferred

Minimum of one year of experience in customer service  

Basic computer skills with proficiency in data entry, keyboarding skills

Bilingual (English/Spanish) preferred

Scheduled hours and/or work locations are subject to change

PHYSICAL ACTIVITIES AND REQUIREMENTS:

Finger Dexterity: Using fingers to make small movements such as typing or picking up small objects.

Talking: Frequently conveying detailed or important instructions or ideas accurately, clearly, or quickly.

Hearing: Able to hear average or normal conversations and receive ordinary information.

Repetitive Motions: Frequently and regularly using the wrists, hands, and fingers.

Visual: Average, ordinary, visual acuity necessary to prepare or inspect documents or other materials.

Physical: Physical work involving bending, stooping, standing most of the time. May have to lift folders, files, papers, equipment, and other such items weighing up to approximately 25 lbs.

CommuniCare

CommuniCare is a full-service primary healthcare system offering pediatric medicine, family medicine, senior care, women's health, senior care, teen health, sports medicine, neurology, rheumatology, cardiology, dermatology, dental, behavioral health, vision care, and telemedicine in Bexar, Hays, and Kendall counties. We deliver our care through 25+ clinic locations utilizing integrative primary care practice, highly trained healthcare providers, state of the art diagnostic equipment, and electronic health records. Our focus is to always provide exceptional care and treat our patients like family. Our Mission To improve the health of those we serve with a commitment to excellence in all we do. Our Vision Be the premier primary health care system of choice. This health center receives HHS funding and has Federal Public claims, including medical malpractice claims, for itself and it's covered individuals. This is a Federal Tort Claims Act (FTCA) deemed Organization.
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