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About the Role

The Patient Services Representative handles front office functions, supporting Ryan Health's mission and goals.

Responsibilities

• Check in patients and create same-day visits as needed.
• Collect copays from insured patients and fees from uninsured patients, including outstanding balances.
• Verify insurance coverage and bill patient insurance for services.
• Direct third-party and privately insured patients to the Patient Accounts Department.
• Obtain referrals and authorizations for specialty services before processing patient visits.
• Screen patients for sliding fee eligibility.
• Inform eligible patients about available entitlements (e.g., Medicaid, Managed Care, ADAP) and refer to appropriate staff.
• Balance patient revenue for bank deposits.
• Collect, ensure signing, and scan patient information into the patient hub.
• Assist patients in changing their PCP by contacting insurance plans.
• Capture patient photos using appropriate equipment when authorized.
• Update and recertify patient registration information, including changes to income, insurance, address, telephone, or dependents.
• Refer patients to Ryan Health departments and community or social agencies as needed.
• Check out patients after booking appointments per provider instructions.
• Process telephone encounters efficiently and appropriately.
• Book and status referral requests for diagnostic and procedure orders.
• Schedule and status urgent, STAT, and high-risk referrals per procedure.
• Review practitioner schedules and mark no-show appointments.
• Verify patient address and telephone number for certified mail.
• Consult with providers or authorized staff when overriding schedules.
• Serve as Greeter when assigned by Supervisor.
• Verify detailed insurance information for all services, including Commercial, MLTC, and supplemental plans.
• Screen and complete insurance applications for eligible patients.
• Process payment plans and itemized bills as applicable.
• Assist patients with insurance restrictions.
• Maintain and update insurance verification via the Electronic Medical Record (EMR) system.
• Update and maintain information per current procedure.
• Attend assigned trainings and webinars.
• Ensure initiation of appropriate Specialty Referral Forms with all required information, including visits and expiration dates.
• Fax referral forms and supporting documents (e.g., progress notes, radiology reports, lab results) to off-site specialists.
• Obtain prior authorization for specialty visits when required by insurance.
• Schedule appointments with off-site specialists based on practitioner notes or patient preference.
• Document specialty appointment date, time, and location in the patient's Electronic Health Record (EHR).
• Maintain assigned referrals according to Network referral management policy and procedure.
• Process, monitor, and reconcile urgent, STAT, and high-risk referrals.
• Ensure urgent, STAT, and high-risk referral appointments are scheduled within specified Network timeframes.
• Monitor urgent, STAT, and high-risk specialty appointments to verify patient attendance.
• Obtain consultation reports from specialty providers to reconcile and address urgent, STAT, and high-risk referrals.
• Review monthly reports of urgent, STAT, and high-risk referrals to track processing timeliness.
• Maintain and update incoming referrals to ensure all off-site appointments are scheduled.
• Document the status of off-site specialty appointments in the patient's EHR.
• Contact patients with appointment information via their preferred method.
• Print and mail completed referral forms to patients.
• Call patients with appointment information if the appointment is within five business days.
• Review billing and global alerts before processing patients.
• Report problems or unusual occurrences to supervisor immediately.
• Perform other duties and projects as assigned.

Requirements

• Experience in front office healthcare environment.
• Ability to respect patient confidentiality.
• Working knowledge of Electronic Health Record systems.
• High School Diploma or GED.
• Experience with eClinicalWorks electronic health record system (Preferred).
• Experience working in a community or human services agency (Preferred).

Skills

• Working knowledge of Electronic Health Record systems.
• Excellent communication skills.
• Excellent interpersonal skills.
• Strong customer service skills.
• Bilingual English/Spanish (Preferred).
• Professional, courteous, and respectful patient interaction.
• Ability to provide age-appropriate patient care.
• Teamwork and cooperation skills.

Location

• New York, NY 10009

Work Type

• Full Time
• Day Shift

Experience Level

• Entry Level

Education Level

• High School Diploma
• GED

Salary/Compensations

• $26.93 - $28.49 Hourly

Equal Opportunity

• Ryan Health is an Equal Opportunity Employer and does not discriminate on the basis of age, color, disability, ethnicity, marital or family status, national origin, race, religion, sex, sexual orientation, gender identity, military veteran status, or any other characteristic protected by law.