Customer Service Representative

C andidates must have previous scheduling experience

Performs a variety of complex administrative duties for patients in need of routine and/or urgent appointments, medical procedures, tests, and associated ancillary services in an ambulatory in/outpatient setting. Assess patients' needs, including but not limited to, financial counseling, interpreter services, social services and refers to appropriate person or area. Alerts providers to emergent patient care needs.

-Greets visitors and/or patients for scheduled and/or urgent care appointments and procedures.
-Confirms and verifies patient demographic and insurance information.
-May collect co-payments from patients upon arrival.
-Obtains signatures of consent from patient/Client for treatment authorization and insurance/billing information.
-Assess patients' needs, including but not limited to, financial counseling, interpreter services, social services and refers to appropriate person or area.
-Receives and directs phone calls.
-Connects the patient's call to the provider or responds to the patient and takes messages as directed.
-Schedules urgent care appointments as needed and directed by clinicians.
-Schedules patients for treatment by multiple providers and treatment areas, and arranges a variety of associated tests and procedures according to established guidelines and specific criteria.
-Prioritizes appointments in a manner that fosters optimum patient care, efficient utilization of clinical staff, as well as resources.
-Ensures tests and procedural prep information is provided to patients verbally, mail, and/or by the patient portal as necessary.
-Collaborates with insurers to obtain patients' prior-authorizations for procedures and tests as needed.
-Follows guidelines established by insurers to ensure that pre-authorization, pre-certification, and clinician referrals for treatment are obtained prior to patient visits.
-Complies with referral management regulations.
-Verifies eligibility for procedures or tests from various health care institutions.
-Follows up to correct discrepancies.
-May facilitate patient prescription renewal matters, (via telephone, fax, and email), within scope of authority as directed by clinicians.
-Preps the patient's information for clinicians for scheduled patient visits as needed.
-Scrubs Patient Encounter information and submits electronically.
-Reviews and audits billing discrepancy reports and researches errors for resolution as directed by office or clinical management.
-Maintains accurate and timely records, logs, charges, files, and other related information as required.
-Performs a variety of related administrative and clerical duties, such as retrieving files distributing mail and other records, faxing, collating, data entry, and relaying messages to clinicians, residents and staff.
-May prepare special reports or spreadsheets for clinicians as requested.
-Collects co-payments from patients for visits, maintains records or makes daily cash deposits from patient visits.
-Calculates daily totals of co-payments received for submission to the second tier for co-payment reconciliation.
-Composes, or selects standard form letters for clinician's response to routine inquiries and procedures, such as back-to-school authorizations.