Patient Service Representative

Responsibilities

• Serve as the primary point of contact for patients, addressing inquiries and ensuring effective communication between patients and healthcare providers.
• Greet patients and visitors with a warm and friendly demeanor.
• Check in patients for appointments and verify personal and demographic information.
• Direct patients to appropriate waiting areas or examination rooms.
• Accurately gather and input patient demographic, insurance, medical, and financial information into the practice management system.
• Document patient consent and ensure compliance with regulatory requirements.
• Enter and update insurance information in the practice management system in a timely and accurate manner.
• Verify patient insurance eligibility and coverage using multiple systems.
• Confirm prior authorizations and primary care provider (PCP) assignments; assist in resolving access issues.
• Verify effective dates and benefit details including co-pays, PCP site, and outstanding balances.
• Work closely with Health Benefits Navigators to resolve issues for uninsured or underinsured patients.
• Address eligibility alerts, electronic actions, and telephone encounters to correct patient accounts.
• Contact patients with inactive insurance to obtain updated information in advance of appointments.
• Schedule, reschedule, or cancel patient appointments as needed.
• Provide patients with appointment details and preparation instructions.
• Inform patients of co-pays, outstanding balances, and other financial responsibilities.
• Collect payments and provide receipts as required.
• Educate patients on payment options including cash, check, credit card, and online payments (e.g., MyChart).
• Provide information on insurance coverage and financial assistance programs, including sliding fee scale options.
• Refer patients to Health Benefits Navigators when appropriate.
• Promote and assist patients with Patient Portal enrollment and respond to portal requests per protocol.
• Deliver exceptional customer service and maintain a welcoming environment.
• Use effective questioning and listening skills to support telephone and in-person communication.
• Resolve patient complaints and concerns professionally and in a timely manner.
• Maintain patient confidentiality and respect patient dignity at all times in compliance with HIPAA.
• Communicate effectively with care teams to ensure smooth patient flow.
• Maintain a clean, organized, and professional front desk environment.
• Monitor office supplies and request restocking as needed.
• Collaborate with providers, nurses, and medical assistants to support patient care.
• Assist in coordinating referrals to specialists or other departments.
• Participate in departmental meetings and trainings as required.

Qualifications

• High school diploma or equivalent; additional education in healthcare administration or related field preferred.
• Experience in a healthcare or customer service environment preferred.
• Strong communication and interpersonal skills.
• Proficiency in Microsoft Office and EHR systems.
• Ability to multitask and work effectively under pressure.
• Knowledge of HIPAA and healthcare regulations preferred.
• Bilingual language skills highly preferred.