Patient Services Representative

We need to produce HTML fragment with sections: Use

for section headings like About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. We must include only sections that have real specific content. The posting includes Position Overview, Essential Functions (which can be Responsibilities), Qualifications (including Minimum Experience and Skills Required, Education..., Preferred Qualifications, Competencies Required, Minimal Training Time, Working Conditions, Physical Demands, Work Environment, Disclaimer, Equal Opportunity Employer). We need to remove boilerplate: cookie/navigation/legal/EEO/equal-opportunity/scam-warning boilerplate, duplicated lines, application instructions. So we should drop Equal Opportunity Employer, Disclaimer maybe? The disclaimer is legal boilerplate; we should remove. Also "Minimal Training Time" maybe part of Qualifications? Could be a separate section but not required headings. We can fold into Qualifications or maybe a separate "Details". But we must use only the allowed headings: About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. We need to map content. We have Position Overview -> could be About the role. Essential Functions -> Responsibilities. Qualifications -> includes Minimum Experience and Skills Required, Education..., Preferred Qualifications, Competencies Required, Minimal Training Time, Working Conditions (Physical Demands, Work Environment). Those could go under Qualifications or Requirements? The headings we have: Requirements (maybe for mandatory qualifications), Qualifications (maybe for preferred?), Skills (maybe for competencies). But we need to decide. We must not repeat job title as heading. No Job ID. We must not create sections like Benefits, Pay, Schedule unless posting actually states them. The posting does not mention benefits, pay, schedule. So we should NOT include those headings. Thus we will have sections: About the role, Responsibilities, Requirements, Qualifications, Skills. Possibly also Working Conditions? Not a standard heading; we could fold into Qualifications or Requirements. We need to preserve all substantive information. So we need to include details from Position Overview, Essential Functions, Qualifications (minimum experience, education, preferred qualifications, competencies, minimal training time, working conditions). We must not invent or summarize away detail. Must keep specifics. We need to use

• for any list of duties/requirements/benefits, and

  for prose. Thus for Responsibilities we will list each duty as

• . For Requirements we list mandatory qualifications (experience, skills, education). For Qualifications we list preferred qualifications. For Skills we list competencies. We need to be careful not to duplicate. Let's extract: Position Overview: "The Patient Services Representative is responsible for handling front office functions. This work is carried out in support of the mission and goals of Ryan Health." That's prose. Essential Functions: a long list of duties. We'll turn each bullet into
• . Need to preserve all details. Let's list them: - Patient Processing: Check in patient’s visit and create same day visits when necessary. - Collect copays from insured patients and appropriate fees from uninsured patients, including any outstanding balances. - Verify insurance coverage using appropriate equipment, and bill patient’s insurance for services. - Direct 3rd Party, private insured patients to Patient Accounts Department. - Ensure that referrals and authorization for Specialty services are obtained before processing patient’s visit. - Screen patient for Sliding fee eligibility - Inform eligible patients of assistance available for entitlements, including but not limited to Medicaid plans, Managed Care plans accepted at the Center, ADAP and refer them to appropriate staff. - Balance patient revenue collected for bank deposit. - Orient patients to services, procedures, and information regarding the William F. Ryan Community Health Center, including but not limited to hours, fees, scheduling and canceling appointments, patient rights, and Board of Directors. - Collect and ensure all patient information is appropriately signed and scanned into the patients’ hub. - Assist the patient when necessary to change PCP by calling insurance plan. - Use appropriate equipment to capture patient photo when authorized by the patient. - Update/recertify patient registration information, as necessary, or when patient reports a change, including but not limited to income, insurance, address, telephone, number of dependents, etc. - Refer patients to appropriate Ryan Health departments and community or social agencies as needed. - Check-out patients after booking all appointments as per provider instructions. - Ensure that telephone encounters are processed efficiently and appropriately. - Book and/or Status referral requests appropriately including but not limited to Diagnostic and procedure orders. - Schedule and status urgent/STAT/High Risk referrals as per procedure. - Review practitioner schedules and mark no-show appointments. - Verify patient address/telephone number for certified mail. - Consult with provider and/or authorized staff when provider’s schedule must be overridden. - Pose as Greeter when assigned by Supervisor - Insurance Processing: Verify detailed insurance information for all services provided at the Center, including but not limited to Commercial, MLTC and supplemental plans. - Screen and complete insurance applications for eligible patients - Process payment plans/bills, when applicable, including but not limited to Itemized bills. - Process Utilization Thresholds. - Assist patients with insurance restrictions. - Maintain and update the insurance verification via electronic medical Record (EMR) system - Update and maintain information per current procedure. - Attend trainings and webinars as assigned by Supervisor. - Referral Processing: Ensure the appropriate Specialty Referral Form, if required, has been initiated and that all required information is provided; including the number of visits and expiration date of the referral. - Fax referral form and supporting documents (i.e. progress note, radiology reports, laboratory results) as attached by the practitioner, to Off-Site specialists via fax. - Obtain prior authorization for specialty visits, when required by the patient’s insurance carrier. - Schedule appointments to the appropriate off-site specialist as per the practitioner’s note, or patient’s preference. - Document the specialty appointment date, time and location in the patient’s Electronic Health Record (EHR) - Maintain assigned referrals in accordance with the Network’s referral management policy and procedure. - Process, monitor, and reconcile Urgent/STAT/High-Risk referrals. - Ensure appointments for Urgent/STAT/High-Risk referrals are scheduled in accordance with the timeframe specified in the Network’s referral processing and tracking policy and procedure. - Monitor Urgent/STAT/High-Risk specialty appointments to verify patient attended the appointment. - Obtain consultation reports from specialty providers in order to reconcile and address Urgent/STAT/High-Risk referrals. - Review monthly report of all Urgent/STAT/High-Risk referrals to track metrics related to the timeliness in which referrals are processed and addressed. - Responsible for maintaining and updating incoming referrals to ensure that all off-site appointments are scheduled. - In the patient’s EHR, document the status of off-site specialty appointments. - Contact the patient with appointment information, via the patient’s preferred method of contact. - Print and mail completed referral form to patient. - Call the patient with appointment information when the appointment date is within five business days or less. - Other: Review billing/global alerts before processing patients. - Immediately report any problems or unusual occurrences to supervisor. - Other duties and/or projects as assigned. That's a lot. Now Qualifications: Minimum Experience and Skills Required: - Experience in front office healthcare environment. - Must enjoy working with the public and be able to respect patient confidentiality. - Working knowledge of Electronic Health Record systems. - Excellent communication and interpersonal skills. - Strong customer service skills. Education, Licenses And/or Certifications Required: - High School Diploma or GED. Preferred Qualifications: - Experience with eClinicalWorks electronic health record system. - Experience working in a community or human services agency. - Bilingual English/Spanish. Competencies Required: - Customer Service: Professional, courteous and respectful attitude in dealing with patients. - Demonstrate the knowledge and skills necessary to provide care appropriate to the age of the patient served. - Commits to exceeding expectations of the patient. - Cooperation/Teamwork: Works well with others. - Contributes input to improve outcomes. - Asks others for opinions and feedback; provides feedback in a tactful respectful way. - Minimal Training Time: 90-day probationary period. Working Conditions: - Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is frequently required to sit, stand, talk and hear. The employee is occasionally required to move about the office; use hands and fingers to feel, handle, or operate office equipment. Specific vision abilities required by this job include close vision and the ability to adjust focus. - Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The work is primarily in an ambulatory primary care setting which includes the unpredictability in behaviors of individuals and acute and chronic infectious diseases which may be contagious. Adequate preparation and precaution is necessary. We should not include Disclaimer or Equal Opportunity Employer. Now we need to map to headings. We have: About the role: Position Overview paragraph. Responsibilities: Essential Functions list. Requirements: Minimum Experience and Skills Required + Education, Licenses And/or Certifications Required (maybe combine as Requirements). Could also include Working Conditions? But Working Conditions is not a requirement per se; it's more about job environment. Could be placed under Qualifications? But we have Skills heading for competencies. Let's assign: - Requirements: Minimum Experience and Skills Required + Education, Licenses And/or Certifications Required. - Qualifications: Preferred Qualifications. - Skills: Competencies Required + Minimal Training Time + Working Conditions (Physical Demands, Work Environment). However Working Conditions is not a skill but we can include under Skills? Might be better to put under Qualifications? But we have no heading for Working Conditions. The instruction says prefer a few substantive sections over many thin ones. So we can fold Working Conditions into Qualifications or Skills. Since Qualifications already has preferred qualifications, we could add Working Conditions there as a subsection? But we must use
  • for any list. We could make a

    for prose describing Physical Demands and Work Environment. That's okay. Thus: Skills section: list competencies (Customer Service, Cooperation/Teamwork) as

  • . Also include Minimal Training Time as
  • . Then a

    for Physical Demands and Work Environment (maybe two paragraphs). That preserves details. Now we need to ensure we don't include boilerplate like "Reasonable accommodations may be made..." that's part of Working Conditions; we keep it. Now produce HTML fragment:

    About the role

    The Patient Services Representative is responsible for handling front office functions. This work is carried out in support of the mission and goals of Ryan Health.

    Responsibilities

    • Patient Processing: Check in patient’s visit and create same day visits when necessary.
    • Collect copays from insured patients and appropriate fees from uninsured patients, including any outstanding balances.
    • Verify insurance coverage using appropriate equipment, and bill patient’s insurance for services.
    • Direct 3rd Party, private insured patients to Patient Accounts Department.
    • Ensure that referrals and authorization for Specialty services are obtained before processing patient’s visit.
    • Screen patient for Sliding fee eligibility
    • Inform eligible patients of assistance available for entitlements, including but not limited to Medicaid plans, Managed Care plans accepted at the Center, ADAP and refer them to appropriate staff.
    • Balance patient revenue collected for bank deposit.
    • Orient patients to services, procedures, and information regarding the William F. Ryan Community Health Center, including but not limited to hours, fees, scheduling and canceling appointments, patient rights, and Board of Directors.
    • Collect and ensure all patient information is appropriately signed and scanned into the patients’ hub.