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Patient Service Representative Behavioral Hea in Visalia, California at Tule River Indian Health Center Inc

NewSalary: $21.00 - $25.00/hr
Tule River Indian Health Center Inc
Visalia, California, 93277, United States
Posted on
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Job Description

Position Summary:

Under the direction of the Behavioral Health Office Manager, the Patient Services Representative serves as the initial point of contact for clinic flow, patient communication, interview incoming patients or representative and enters required information for admission into computer systems. In this role, the Patient Services Representative demonstrates excellent customer service skills and greets patients in a friendly and professional manner while assuming responsibility for scheduling all patient appointments appropriately; updating patient information routinely at each visit, including collecting any co-pays owed; and documenting all patient “no-shows”. The Patient Services Representative is broadly responsible for identifying and addressing deficiencies in registered patients’ record files that may impact patient eligibility and/or influence decision-making regarding Purchased Referred Care (PRC) patients. In this capacity the Patient Services Representative is responsible for attending trainings and assisting with the accurate update and exchange of patient information between Electronic Health Records (EHR) systems, auditing PRC patient records to identify missing patient information and coordinating communication efforts with the PRC patient to ensure adequate notification. In addition, the Patient Services Representative must be able to communicate well and be able to establish rapport with the patients and their families. He/she must be sensitive to the needs of the Indian community; its cultures, traditions, and values and express a genuine enthusiasm for its well-being.

Essential Duties and Responsibilities:

  • Greets patients at the front desk, answers telephones, takes telephone messages, schedules appointments, and follow up appointments as needed.
  • Obtains/ updates patient information in the Electronic Health Records (EHR) system at every visit.
  • Verifies patient insurance/ eligibility at every visit prior to being seen and refers to CHS or Social Services when needed.
  • Reviews notes in the EHR system verifying registration is up to date.
  • Collects any applicable co-pays at every visit prior to being seen by a provider.
  • Ensures that all appropriate forms are completed thoroughly and placed on the chart prior to the patient being seen.
  • Assists in ordering office supplies and forms, and maintaining adequate stock of all forms.
  • Assures that daily sign-in sheets are complete with insurance eligibility and forwards sign-in sheets daily to the Finance department.
  • Assures that medical packets are complete and forwards then to the Administration Assistant daily.
  • Follows up with all “no-show” appointments, documents in patient’s medical record, and sends “no-show” letters to patients who failed to make their appointments.
  • Prints daily patient schedule for behavioral personnel.
  • Confirms next day appointments daily; reminding patients to bring in all needed paperwork for patient registration, co-payments (if applicable) and verify insurance and address are accurate.
  • Turns-in call log and waitlist spreadsheets daily to Office Manager.
  • Interviews patients to obtain pertinent patient registration information, that is, demographic and alternate resources information to enable the Fiscal Office to bill for health care services provided from all alternate resources, including non-beneficiaries.
  • Assists patients in completing new or updated forms for the Resource and Patient Management System (R.P.M.S.) and EHR system. Documents items received and files updated forms into charts located in the Purchased/Preferred Care (PRC) department.
  • Determines the eligibility of patients seeking health care who have not been treated at the facility, by obtaining the certificate of Indian Blood or other documentary proof of tribal membership, according to I.H.S. guidelines.
  • In the event of claim information discrepancy; determines source of discrepancy and implements corrective action as appropriate to ensure that the claims can be processed for payment.
  • Collects third party, private insurance cards, Medicaid cards or other health care cards, photocopies and explains the program to the beneficiaries, that is, Medicare, Medicaid, private insurance and Managed Care organizations as to billing for their health care services they received at the Tule River Indian Health Center Inc. facility.
  • Interviews patients to obtain information to initiate a new Patient Registration record and communicates with Medical Records to reactivate/inactivate stored record. Enters all information into the Resource and Patient Management System (R.P.M.S) and EHR systems and prints appropriate forms.
  • Handles all patient information confidentially.
  • Keeps work station well organized and tidy.
  • Participates in all required staff meetings.
  • Performs general office duties or other responsibilities as needed and assigned.
  • QUALIFICATIONS: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed here are representative of the knowledge, skills, and/ or abilities required. In accordance with the American with Disabilities Act (ADA), reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  • Possess a Valid California Driver’s License and be insurable with the Tule River Indian Health Center Inc. insurance agency throughout employment.
  • Must pass pre-employment drug & alcohol test.
  • Must pass pre-employment physical.
  • Must pass background check.
  • Must maintain a professional appearance and attitude.
  • Must be punctual and reliable.
  • Must maintain absolute confidentiality regarding patients per HIPAA and TRIHCI policies.
  • Must be able to multitask, prioritize and handle many incoming calls or patients at once.
  • Must demonstrate the ability to maintain accurate records and preparing clear and accurate reports for informational, auditing, and operational use, including capacities for attention to detail and for reviewing and verifying accuracy of data.
  • Experience working in a health care facility setting.
  • Possess experience in scheduling patients according to availability.
  • Must possess good communication skills, be able to effectively communicate with diverse populations, and be willing to convey responsibilities to patients.
  • Hiring preference is given to qualified American Indians in accordance with the Indian Preference Act (title 25, U.S. code § 472 & 473). Applicants claiming Native American/ Indian Preference must submit Indian verification, certified by Tribe of affiliation or other acceptable documentation of Native American/ Indian heritage.

    Knowledge, Skills, and Abilities

  • Knowledge of safety regulations as they apply to a clinical setting.
  • Knowledge of tracking, reporting, and maintaining data entry compliance.
  • Ability to demonstrate the competency and integrity to maintain the confidentiality of organizational, employee, and client records.
  • Ability to perform physically demanding tasks on a regular basis.
  • Ability to provide a drug & alcohol free workplace (zero tolerance).
  • Ability to attend staff meeting and trainings.
  • Ability to work flexible hours as needed.
  • Ability to work weekends as needed.
  • Ability to demonstrate strong interpersonal skills and the ability to interact effectively with a variety of individuals.
  • Ability to demonstrate basic levels of computer literacy, with a functional understanding of Microsoft Windows Operating Systems in an office setting.
  • Ability to work independently in carrying out assignments while remaining reliable and dependable.
  • Ability to read and comprehend simple instructions, short correspondence, and memos.
  • Ability to write simple correspondence.
  • Ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization.
  • Ability to apply common sense understanding to carry out detailed written or oral instructions.
  • Ability to demonstrate professional competency in office and healthcare abilities, including the maintenance of client confidentiality.
  • Ability to deal with problems involving a few concrete variables in standardized situations.
  • Ability to provide an updated DMV Printout upon request.
  • Skills of dependability and punctuality in carrying out work assignments.
  • Education and/ or Experience

    1. High school diploma or general education degree (GED); or

    2. Two (2) years or more related experience and/or training; or

    3. Equivalent combination of education and experience

    Certificates, Licenses, Registrations

  • Possess a current, valid California driver’s license and be insurable through the Tule River Indian Health Center Inc insurance agency throughout employment.
  • Possess First aid/ CPR at the BCLS level are required or obtained within three (3) months of hire.
  • Contingencies

    TRIHCI maintains a drug and alcohol-free workplace, and all offers of employment are contingent on the successful completion of a criminal background check, a post-offer drug test and physical, and verification of each candidates right the work in the United States.

    Physical Work Environment: the description provided here is representative of those conditions in which the Patient Services Representative will be required to perform the essential function of this position. As stated earlier, reasonable accommodations may be made to enable individual with disabilities to perform the essential functions of this position.

    While performing the duties of this position, the Patient Services Representative is situated in a standard office environment within the health center, where there is little or no exposure to variations in the either or other similar elements. The Patient Services Representative will primarily be stationed in the medical reception area of the health center but will also move about the health center to meet with physicians, patients, and co-workers. Consequently, the Patient Services Representative must:

    1. Possess the mobility to work in a standard office setting (i.e. walk, stand, or sit for extended periods of time).
    2. Posses the ability to use standard office equipment to write, type, copy, fax, or perform other duties.
    3. Possess the strength to life and carry supplies weighing up to 10 lbs. repeatedly and up to 30 lbs. intermittently.
    4. Possess the visual acuity to read printed material and a computer screen.
    5. Demonstrate hearing and speech capabilities that allow him/her to communicate in person and over the telephone as required.

    The clinical setting at TRIHCI is categorized by OSHA and a Blood-Borne Pathogen Category I facility. Thus, there may exist the potential for exposure to blood, body fluid/tissue, and infectious wastes. There also exist the potential for exposure to chemicals, biological, toxicants, and irradiants found on-site.

    Disclaimer:

    The position description lists the major duties and requirements for the Patient Services Representative position as established by subject-matter experts at the time of this document’s creation. This position may require additional performance of duties and responsibilities beyond those outlined in this document, and thus may require additional sets of knowledge, skills and abilities not fully articulated herein.

    Job Location

    Visalia, California, 93277, United States

    Frequently asked questions about this position

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