Patient Service Representative

Northern Light Health - Gorham, ME

Full-time - Entry Level

Gorham, ME

Ambulatory Health Care Services

About the position

The Patient Service Representative at Northern Light Mercy Hospital is responsible for performing various daily office functions within a multi-physician outpatient practice. This role serves as a key liaison between the practice and its patients, ensuring a high level of customer service while managing sensitive patient information in compliance with HIPAA and hospital policies. The representative will actively participate in patient safety initiatives and contribute to improving patient outcomes.

Responsibilities

• Treats all patients and customers in a polite, prompt, and helpful manner in keeping with Organization Values and Standards.
• Actively participates in regular huddles and team meetings to improve workflows and contribute to improving patient population outcomes.
• Maintains productivity and efficiency in workflow to accommodate the volume and acuity of the practice.
• Handles difficult conversations with patients and internal customers effectively.
• Registers all patient demographic and insurance information accurately at the time of appointment and provides necessary forms for completion in accordance with all insurance regulations and practice policy.
• Provides excellent customer service for incoming inquiries, screens calls, documents detailed messages, and routes them to the appropriate individual in a timely manner.
• Schedules, reschedules, confirms, acknowledges, and cancels patient appointments including surgical and ancillary services.
• Monitors daily schedules, notifying manager or all team members of potential issues or access opportunities.
• Collects co-pays and patient due balances.
• Utilizes insurance verification system and takes appropriate action based on eligibility response.
• Obtains patient consents and signatures, schedules follow-up appointments when indicated.
• Performs end-of-day reconciliation of payments, appointments, and validation.
• Investigates and problem solves insurance denials on a monthly basis to recover lost revenue and proactively submit clean claims.
• Participates in the referral process as outlined by Medical Associates.
• Initiates, receives, and/or processes insurance and services referrals in compliance with the patient's plan and in conjunction with the Medical Associates referrals protocol.
• Proactively identifies, reports, and participates in the resolution of any potential or actual patient safety issues.
• Processes health information requests in accordance with Organization and MMA policy.
• Screens and invites patients to the electronic patient portal.
• Displays cooperative behavior and interacts positively and effectively with others to promote a team environment.
• Creates, maintains, and pulls patient charts, either physically or electronically, as outlined by the practice.
• Acts as a back-up for coworkers as needed.
• Ensures compliance with hospital, state, and federal regulations.
• Works in a way to uphold HIPAA standards, in compliance with the law.
• Performs additional duties as required or assigned to maintain the overall efficiency and continuity of the facility.

Requirements

• High School Diploma or General Educational Development (GED) is required.
• Ability to handle difficult conversations with patients and internal customers.
• General understanding of insurance plans with a greater detailed knowledge of the most frequently seen insurance plans.
• Ability to maintain productivity and efficiency in workflow to accommodate the volume and acuity of the practice.

Nice-to-haves

• Experience in a healthcare setting is preferred.
• Familiarity with electronic health records (EHR) systems.

Benefits

• $3,000 sign-on bonus for eligible candidates.