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About the Role
The Patient Services Representative is responsible for handling front office functions in support of Ryan Health's mission and goals.
Responsibilities
- Check in patients and create same-day visits when necessary.
- Collect copays and appropriate fees from patients.
- Verify insurance coverage and bill patient insurance.
- Direct patients to the Patient Accounts Department as needed.
- Ensure referrals and authorizations for specialty services are obtained.
- Screen patients for Sliding Fee eligibility and inform them of available assistance.
- Balance patient revenue collected for bank deposit.
- Orient patients to services, procedures, and information about the William F. Ryan Community Health Center.
- Collect and ensure all patient information is signed and scanned into the patient's hub.
- Assist patients in changing PCP by calling the insurance plan.
- Use appropriate equipment to capture patient photos when authorized.
- Update/recertify patient registration information as necessary.
- Refer patients to appropriate Ryan Health departments and community or social agencies.
- Check-out patients after booking all appointments.
- Ensure telephone encounters are processed efficiently and appropriately.
- Book and/or status referral requests, including 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.
- Act as a Greeter when assigned by Supervisor.
- Verify detailed insurance information for all services provided.
- Screen and complete insurance applications for eligible patients.
- Process payment plans/bills, including itemized bills.
- Process Utilization Thresholds.
- Assist patients with insurance restrictions.
- Maintain and update insurance verification via EMR system.
- Attend trainings and webinars as assigned by Supervisor.
- Ensure appropriate Specialty Referral Form is initiated and all required information is provided.
- Fax referral forms and supporting documents to Off-Site specialists.
- Obtain prior authorization for specialty visits when required.
- Schedule appointments with appropriate off-site specialists.
- Document specialty appointment date, time, and location in the 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 within specified timeframes.
- Monitor Urgent/STAT/High-Risk specialty appointments to verify patient attendance.
- Obtain consultation reports from specialty providers to reconcile and address referrals.
- Review monthly reports of Urgent/STAT/High-Risk referrals to track metrics.
- 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 the patient with appointment information via their preferred method.
- Print and mail completed referral forms to patients.
- Call patients with appointment information when the appointment date is within five business days or less.
- Review billing/global alerts before processing patients.
- Immediately report any problems or unusual occurrences to supervisor.
- Perform other duties and/or projects as assigned.
Requirements
- Experience in a front office healthcare environment.
- Ability to respect patient confidentiality.
- Working knowledge of Electronic Health Record systems.
- Excellent communication and interpersonal skills.
- Strong customer service skills.
- Experience with eClinicalWorks electronic health record system (preferred).
- Experience working in a community or human services agency (preferred).
- Bilingual English/Spanish (preferred).
- Professional, courteous, and respectful attitude in dealing with patients.
- Demonstrate the knowledge and skills necessary to provide care appropriate to the patient's age.
- Commitment to exceeding patient expectations.
- Works well with others.
- Contributes input to improve outcomes.
- Asks others for opinions and feedback; provides feedback in a tactful respectful way.
- 90-day probationary period.
Skills
- Front office operations
- Patient processing
- Insurance verification
- Referral processing
- Electronic Health Records (EHR)
- Customer service
- Communication
- Interpersonal skills
- Confidentiality
- Bilingual English/Spanish (preferred)
Location
- West 97th Street - New York, NY
Work Type
- Full Time
- Day Shift
Experience Level
- Entry
Education Level
- High School Diploma or GED
Salary/Compensations
- $27.96 - $29.56 Hourly
About the Company
- Ryan Health is an Equal Opportunity Employer.
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.