Front Office Representative

ESSENTIAL FUNCTIONS

• Promptly greets and acknowledges patients.
• Informs MAs and Providers of patient’s arrival through CPS, using Appointment Status’.
• Instructs patients in completion of medical history and patient information forms, and makes any necessary corrections to the patients account.
• Obtains accurate, complete demographic and insurance information and financial contract / consent on patient paperwork, as well as reviewing patients and guarantors to obtain accurate information assuring all necessary documents are populated and signed correctly.
• Makes sure all required Authorizations and or referrals are attached to the appointment for that DOS.
• Responsible for identifying and collecting co-payments, co-insurances and past due account balances.
• Explains financial requirements to the patient in response to patient questions on billing and insurance matters; refers questions regarding more complex insurance/benefits questions to Site Billing Specialist.
• Evaluates patient financial status and establishes payment plans based upon authority levels.
• Responsible for accurately completing and interpreting insurance verification and benefits.
• Notifies patients, family members, physicians and/or supervisors of network insurance coverage issues that may result in coverage reduction.
• Scares all new patient or updated patient information into computer (including: photo ID, insurance cards, referrals, and patient paperwork).
• Schedules follow up appointments, reviews patient's insurance coverage and notifies patient if service requires an authorization or referral and sends request to PCP via CPS.
• Maintains general knowledge of insurance plans accepted by The CORE Institute.
• Communicates with the patients in the lobby if the physician or provider is running behind schedule.
• Responsible for maintaining a secure and accurate cash drawer. Responsible for daily balancing of cash drawer and closing Batch.
• Maintains strictest patient confidentiality.
• Maintains a clean and organized front office workspace.
• Follows established Front Office SOP’s.

EDUCATION

• A high school diploma/GED or equivalent working knowledge preferred.

EXPERIENCE

• Successful candidate must have a minimum of one year of patient registration experience in a medical office or healthcare setting.
• Requires knowledge of insurance rules and regulations, medical terminology, and computer scheduling systems.
• Must be able to communicate effectively with physicians, patients, and the public and be capable of establishing good working relationships with both internal and external customers.
• Previous experience in collecting money is preferred.

KNOWLEDGE

• Knowledge of insurance rules and regulations including eligibility and referral requirements.
• Able to verify eligibility of each payer, per patient according to defined parameters.
• Knowledge of medical terminology and HIPAA Guidelines.
• Computer knowledge, including Windows based programs.
• Bilingual (English/Spanish) strongly preferred.

SKILLS

• Skill in customer service and an understanding of The CORE code of conduct and culture.
• Skill in communicating effectively with physicians, clinical staff and the public.
• Skill in establishing good working relationships with both internal and external customers.

ABILITIES

• Ability to maintain patient confidentiality.
• Ability to communicate with upset and frustrated patients while consistently providing excellent customer service.
• Demonstrate empathy, concern, good listening skills, and compassion for all patients.

ENVIRONMENTAL/WORKING CONDITIONS

• Normal office environment.
• Some travel between various clinic locations.

PHYSICAL/MENTAL DEMANDS

• Requires sitting and standing associated with a normal office environment.
• Some bending and stretching required.
• Manual dexterity using a calculator and computer keyboard.

ORGANIZATIONAL REQUIREMENTS

• HOPCo Mission, Vision, and Values must be read and signed.
• OSHA Requirements and training to include: *Safety Training.