Patient Service Representative

Responsible for performing all aspects of the patient encounter from scheduling appointments, registering new patients, screening by phone or in person all patients through the check-out process.

Essential Functions

(Principal Duties and Job Responsibilities): A. Front Office & Patient Flow Customer Service: Serves as the first point of contact, answering phones in a professional manner, greeting all patients upon arrival, and confirming appointment times. Patient Flow: Directs patients to appropriate clinical areas to ensure smooth operational activity and monitors the waiting room to maintain safety and cleanliness standards.

Communication: Explains walk-in and appointment procedures to prospective patients, referral sources, and the general public. B. Scheduling & Registration Appointment Management: Accurately schedules new and return patient appointments based on physician or student doctor availability and medical specialty protocols. Registration: Obtains, verifies, and records patient demographic and insurance information required by the appointment system.

Insurance Verification: Verifies financial eligibility for all scheduled patients and obtains necessary authorization based on specific insurance requirements. C. Financial & Revenue Cycle Collections: Responsible for point-of-service collections, including co-payments, deductibles, non-covered services, and self-pay balances.

Cash Handling: Receives and processes payments according to cash management policy; balances the cash drawer at the end of every shift/day using the daily balancing proof sheet. Knowledge, Skills and Abilities Required: Medical Terminology: Sufficient proficiency in medical terminology to accurately identify and explain medical procedures to patients, third-party payers, and facility personnel.

Coding & Billing: Knowledge of CPT/CDT and current ICD coding standards (e.g., ICD-10). Insurance Proficiency: Sufficient knowledge of insurance plans to correctly interpret patient financial information and assess the need for prior authorizations and referrals. Office Procedures: Thorough understanding of general medical office procedures and protocols, including familiarity with substance abuse treatment environments.

Records Management: Strict adherence to patient confidentiality standards (HIPAA) and release of information protocols; ability to file accurately using numerical and alphabetical systems. Technology: Proficiency with standard office hardware (computers, copiers, fax machines) and software applications. Knowledge, Skills, Abilities Preferred: Communication: Excellent oral and written communication skills, with professional and courteous telephone etiquette.

Customer Service: Ability to interact positively and professionally with the general public, staff, and clients. Work Ethic: Skilled at managing multiple priorities and working effectively under pressure in a busy clinical environment.

Education and Experience

Education

High School Diploma or GED required. Associate’s degree or relevant certification (e.g., Medical Office Specialist) preferred. Experience: One (1) to two (2) years of experience working in a fast-paced medical office, clinic, or hospital setting required .