West Virginia University Physicians of Charleston – (WVUPC)

                                                                             

Clinical Patient Services Representative

 

Department:   Beh. Med; Medicine;

                        Peds; Ob; Surgery

Area:               Clinical                                                                                                           

FLSA Status:   Non-exempt

Date:               8/2013 (revised)

                                                                                                                                                                       

 

Summary:

 

Greets patients upon arrival at the clinic in a friendly, courteous and respectful attitude.  Sets the tone and first impression of the clinic and WVUPC to the patient.  Schedules patient appointments, collects patient financial and demographic information so patients can be registered at the clinic.  Obtains patient consent to treat and patient financial obligation electronically.

 

Essential Responsibilities and Duties:

 

1.      Prepares clinic.

·       Preps report of scheduled appointments for the day’s clinic; prepares reports for providers, nurses and front desk area, including appointments that were added.

·         May obtains or assists in obtaining authorizations for referrals on appointments added to the schedule for the day.

·         Review patient account ahead of time to determine if a balance exists and note in EPIC.  Seek payment on account at visit.

 

2.      Obtains and verifies all patient information during patient registration process.

·         Registers patient into the clinic while maintaining patient confidentiality.

·         Collects and updates patient financial and demographic information and adds/confirms pharmacy of record for patient.

·         May verify necessary testing prior to visit.

·         Ensures primary care and referring provider data is correct.

·         Gathers insurance information and updates in scheduling system.  Verifies insurance at each visit.

·         Obtains signature for release of information, consent to treat, and billing purposes at each visit and update annually.

·         Collects any co-pay or co-insurance from patient and payments from private-pay patients.  Address self-pay balances with patients at check-in.

·         Obtain authorizations for patient visits and seeks authorizations for referrals.

·         Communicates to clinical staff of late arrivals and “walk-in” appointments and add-ons.

·         Handles emergent cases, as necessary, based on medical guidelines and in consultation with nursing and clinical staff.

 

3.      Processes patient check out after appointment

·         Collects any payment for outpatient visits/procedures for non-covered services or from private-pay patients.

·         Schedules any follow-up appointments and verifies with provider.

·         May schedule follow up tests and obtain necessary authorizations from insurance companies.

·         Provide work/school physician visit verification.

·         Provide visit information to patients seeking reimbursement.

·         Answers and responds to phone calls.

 

4.      Schedules, cancels, reschedules and confirms patient appointments.

·         Makes contact with patient about appointment change and to confirm future visit.

·         Verifies insurance and explains co-payments and co-insurance payments.  Discusses with patient and collects on self-pay balances.

·         Reviews wait list to move patients to open appointment on schedule.  Notifies scheduling staff of potential cancellations and new openings.

 

5.      Maintains cash drawer and prepares daily deposit.

 

6.      Orders and maintains inventory of office supplies.

 

7.      Prepares medical education information packets for patients.

 

8.      Maintain clinic data related to daily census of arrivals, added patients, cancellations and no-shows.

 

9.      Performs other duties as assigned or directed.

 

 

Qualifications:

 

Education and Experience:

 

·         High school diploma or equivalent required.

·         One year of experience in a customer service role or working with the public required.

·         Work experience in a medical office preferred.

 

Required Knowledge, Skills and Characteristics:

 

·         Strong communication skills necessary when interacting with patients and family members, physicians and other support staff.

·         Maintains composure with patients who seem impatient or have received difficult medical information.

·         Must handle stressful situations while demonstrating a friendly, courteous and respectful attitude.

·         Manage multiple tasks at one time while maintaining an attention to detail.

·         Professional appearance and demeanor at all times.

·         Ability to physically move from one area of the clinic to the other throughout the day.

·         Must be able to bend, stoop, stretch and reach above the head to retrieve office materials.

·         May be required to push or pull carts weighing up to 50 pounds.

 

 

The above essential responsibilities and duties describe the level and nature of work performed by the employees assigned to this job.  The description should not be construed as an exhaustive listing of all job duties and responsibilities performed by this job.