Patient Services Representative Temp (Medical & BH)

Since 1970, Indian Health Council, Inc. (IHC) has provided high-quality, compassionate healthcare and support services to the nine Federally recognized American Indian tribes in north San Diego County. With more than 200 employees serving 2 clinic sites, IHC is proud of the diversity of its staff as a reflection of the community it serves. The reward of working at IHC is more than a paycheck and excellent benefits; it is the impact and contribution to the Tribal community that employees value most. If you are passionate about improving the overall health and wellness of our tribal community, IHC is looking for people like you.

About Us
• Patient-Centered Care: Medical, Dental, Behavioral Health, Pharmacy, Social Services
• Research focused: Community Based Participatory grant-funded research programs; we are a Native American Research Center of Health (NARCH)
• Accredited as an ambulatory health care center by AAAHC

Our Philosophy
At IHC, we believe in empowering our patients with knowledge to achieve their healthcare goals. We strive to treat the whole person using a multifaceted approach to include physical, mental, emotional, and spiritual aspects of health and wellbeing.

Our Benefits
PPO medical, dental, and vision insurance with low employee contribution; company-paid life and disability insurance; malpractice coverage for providers; 403B retirement with company matching; generous PTO and Sick time; 14 paid holidays; paid jury service; and paid bereavement leave; reimbursement for professional license(s), and certifications such as CPR and continuing education units. Our facility also qualifies as a high-need area for provider CA State and Federal Loan Repayment Programs.

Reports To: Business Operations Manager

FLSA Status: Non-Exempt

Position Function: Non-clinical

Classification: On-call as needed

Schedule: Varies

Location: Onsite, position may be assigned to work at both IHC locations

SUMMARY:

The PSR performs all the standard PSR functions, serves as the technical point of contact for the front desk and carries out day-to-day operations in accordance with established standards set forth by the Business Operations department. This position works in conjunction with the manager to identify system/process deficiencies and implement improvement strategies.

ESSENTIAL DUTIES AND RESPONSIBILITIES: The information in this job description indicates the general nature and level of work performed. It is not designed to be interpreted as a comprehensive inventory of all duties and responsibilities required of employees assigned to this job position. Duties and responsibilities may change (be assigned or removed) at any time with or without notice.

1. Perform all the standard PSR functions.

2. Greet patients and visitors with emphasis on service excellence; addresses or directs questions/concerns.

3. Explain eligibility criteria to patients and the public regarding clinical service access.

4. Understand and accurately interpret patient eligibility statuses, PRC, Direct, Non-Native.

5. Serve as back-up to the Registration Office, reviews forms for completeness and accuracy.

6. Answer, screen, address, and/or transfer inbound phone calls; utilize round-robin phone que system.

7. Serves as a resource to department personnel regarding established front desk procedures and protocols; appointment scheduling eligibility statuses, patient check in / out.

8. Assists with scheduling problem solving and patient wait times; work to increase efficiency.

9. Schedule patient clinical appointments following established scheduling protocols.

10. Resolve scheduling conflicts and notify patients of changes or cancellations.

11. Work with clinical staff to assess urgency and prioritize appointments for re-scheduling.

12. Understand scheduling protocols and perform PSR functions at multiple department desks.

13. Collect, review, and verify patient insurance/ 3rd party coverage; enter in EPIC system.

14. Assist patients/providers with general insurance and benefits coverage questions.

15. Check patients in for their appointments and generates clinical encounter.

16. Monitor waiting room area and actively communicate with clinical staff.

17. Review and verify patient chart information for accuracy; up-dates demographic, insurance, and client defined fields as appropriate to ensure the patient record is complete and current.

18. Scan and upload patient documents into the EPIC system.

19. Handle a variety of confidential information; adhere to HIPAA rules and regulations.

20. Handle cash daily; accept, and process insurance copayments and specialty services copayments. Accept and accurately post patient account payments.

21. Position may be reassigned during activation of EOP.

SUPERVISORY RESPONSIBILITIES

This position has no supervisory responsibilities.

TRAVEL & DRIVING REQUIREMENTS

· Travel is not required for this position.

· Driving is not required for this position.

EDUCATION AND/OR EXPERIENCE

· High School Diploma or GED required.

· Completion of post-secondary training/certification program preferred.

· Two years of related clinical office experience.

· Two years of experience working with insurances; verifying, sequencing & interpreting benefits.

· Two years of experience working with practice management and electronic health record system; preferably EPIC.

REQUIRED KNOWELDGE, SKILLS, AND ABILITIES

· Knowledge of third-party payers and publicly funded program structures and eligibility requirements.

· Problem solving skills; identifies and analyzes problems, distinguishes between relevant and irrelevant information to make logical decisions.

· Communication skills; expresses ideas and facts in a clear and organized manner; listens effectively and demonstrates that by clarifying information when necessary.

· Technical skills; advanced knowledge of front office policies, standards, and protocols; applies expertise to generate process improvements and solve problems; enhances expertise in peers.

· Resiliency: ability to effectively deal with pressure; remain focused and optimistic; persistent even with adversity and recover easily from setbacks.

· Ability to influence and negotiate; persuades others, builds consensus through give, and take, gains cooperation from others to obtain information and accomplishes goals; facilitates “win-win” situations.

· Initiative; ability to be self-directed, resourceful, and motivated in performing job duties individually or in a team; follows through on assignments; initiates and modifies ideas, methods, and procedures to provide service excellence and accomplish functional responsibilities.

· Productivity Software: Microsoft Office 365; Word, Excel, PowerPoint, Email & Calendar Management (outlook), Teams (video conferencing and meetings), and Share Point.

· Electronic health records software (EPIC preferred).

CERTIFICATES, LICENSES, MEMBERSHIPS AND REGULATIONS

· Current AED CPR certification or attainment within 6 months of hire.

· Applicants must successfully pass a pre-employment physical exam, tuberculin skin test or x-ray and urine drug screen test.

· Health must be adequate to perform all duties of the position.

· Must pass criminal background check.

WORK ENVIRONMENT

The work environment characteristics described are representative of those an employee encounters while performing the essential functions of this job.

· Indoor office environment.

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 position. While performing the duties of this job, the employee is regularly required to sit, use hands to finger, handle, or feel; reach with hands and arms; and talk or hear. The employee frequently is required to stand. The employee is occasionally required to walk and stoop. The employee must regularly lift and/or move up to 10 pounds; may frequently lift and/or move up to 25 pounds, and occasionally lift and/or move up to 50 pounds. Specific vision abilities required by this job include close vision, peripheral vision, and the ability to adjust focus.

CUSTOMER RELATIONS

1. Respond promptly and with caring actions to patients and employees.

2. Maintain professional working relationships with all levels of staff, patients, and the public.

3. Be part of a team and cooperate in accomplishing department/organizational goals and objectives.

QUALITY MANAGEMENT

1. Display knowledge of normal signs of human development and ability to assess and provide age-appropriate care.

2. Contribute to the success of the organization by participating in quality improvement activities.

SAFETY

1. Maintain current knowledge of policies and procedures as they relate to safe work practices.

2. Follow all safety procedures and report unsafe conditions.

3. Use appropriate body mechanics to ensure an injury free environment.

4. Follow all infection control procedures including blood-borne pathogen protocols.

HIPAA/COMPLIANCE

1. Maintain privacy of all patient, employee, and volunteer information. Access such information only on a need-to-know basis and for business purposes only.

2. Comply with all regulations regarding corporate integrity and security obligations.

3. Report unethical, fraudulent, or unlawful behavior or activity.

Indian Preference shall be given in accordance with IHC’s Policies and Procedures.