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Northern Light Health Patient Service Rep III in Brewer, Maine

Job Description Northern Light Eastern Maine Medical Center Department: Cancer Care - Brewer Position is located: Lafayette Building Work Type: PRN / Pool / Per Diem FTE: 0.0001000: Work Schedule: Summary: The Patient Service Representative III is a supporting position and is responsible for a variety of activities related to patient in-take and care. The Patient Service Representative III will also support the Patient Service Representatives I and II as required and may be the first point of contact for patients entering the practice. It involves all of the responsibilities of the PSR II but with a higher level of competency and experience. Activities may include but are not limited to greeting and checking in patients, verifying and updating insurance information and confirming other patient information, scheduling patient appointments, answering phones, updating demographic information, processing referrals, payment collection and posting, charge entry, chart preparation, processing of payroll, tracking of time and attendance, tracking of quality metrics, daily charges, schedule management, patient panels, taking meeting notes, assist with patient complaints ordering office supplies, assisting with practice orientation and training of new staff and other duties as assigned with a minimum of support. The PSR III will also be able to coordinate all components of patient appointments to include tests, surgeries and procedures and may work closely with Central Scheduling. The PSR III will be expected to work with a fair amount of independence applying logic and judgement towards the resolution of practice challenges. The PSR III will serve as a role model of service and professionalism to all supporting staff. This role will provide help with mentoring new staff. Responsibilities: People Communicates Effectively • Demonstrates effective and courteous Customer, Physician/Practice Staff and other hospital staff communication skills • Communicates in a way that conveys understanding and respect to a diverse patient and work population • Answers all calls promptly and courteously • Responds to and resolves issues promptly through effective communication • Uses appropriate chain of command • Feedback is provided in a constructive manner • Demonstrates problem solving skills by responding to and resolving issues promptly through effective communication skills • Maintains adaptability in work schedule to meet patient/departmental needs • Develops and maintains positive working relationships • Acts as a resource to coworkers • Confirms patient identity by using the full name • Participates in problem solving groups as requested • Gives instructions and directions in a clear, understandable manner • Handles patient/family situations that have been escalated to the PSR II in a calm, courteous and informed professional demeanor Attends all practice staff meetings May serve as a receptionist to patients by: • Greeting patients, having patient(s) sign appropriate forms/consents • Verifying and updating demographic/insurance information on all encounter forms and systems per protocol. Notifying registration of changes if applicable • Demonstrating mastery of appropriate practice software and registration tool protocols • Scheduling tests, procedures, referral appointments with scheduling center, agencies and/or other provider groups and forwarding order form and/or records to appropriate depart/office. Documenting information in Patient's chart. Processing insurance referral/prior authorization and document this per protocol • Retrieving and processing messages per protocol Training • May assist with orientating and training/cross-training of new and established employees as assigned • Has the knowledge and the ability to train support staff at all practice levels and for all practice functions, if appropriate • May provide coverage in other areas • Effectively covers other support positions (e.g. switchboard, insurance referrals, and scheduler), if appropriate Service • Provides excellent customer service for both internal and external customers • Responds to communications (phone calls, voice mails, e-mails and IMs) in a timely manner • Demonstrates mastery of and acts as a resource for all systems used in the front office, including scheduling and registration protocols, if appropriate • Takes ownership for determining customers’ needs and offering assistance • Interacts with other NL EMMC functions with confidence, courtesy and professionalism • Assists the practice manager in organizing, coordinating and implementing projects. • Collects and compiles statistical data to assist the practice manager as required • Schedules outpatient testing per orders/referral process, inputs appointment dates and times into patient EMR, if appropriate • Recognizes problems and offers constructive solutions. Is able to implement solutions with direction from the practice manager • Is able to run staff meetings in the practice manager’s absence • Acts as a designee for the safety officer for practice, to include all safety training, conducting safety related drills, documenting all safety procedures. The PSR III will also participate in disaster drills, demonstrate understanding of disaster plan in discussion drills and disaster situations. The PSR III will also perform duties as assigned to meet unusual, emergent and practice needs • 100% documented evidence of attendance of department staff meetings and/or reading/initializing the minutes • Performs other duties as assigned by practice leadership • Consistent and reliable attendance including communication and attempts to find coverage when issues prevent attendance Quality • Reviews material submitted by Health Plans and Managed Care Organizations to gain full understanding of benefit coverage and precertification/authorization, if appropriate • Quality review procedures are followed to ensure accounts are brought to a timely and accurate resolution, if appropriate • Adheres to NL EMMC Code of Conduct and follows all applicable compliance policies and regulations • Ability to prioritize and perform multiple duties, simultaneously • Ability to take ownership of work and follow up on responsibilities • Speaks, spells, and writes clearly, concisely and to the point • Consistently follows Patient Identification IDD by using two patient identifiers related to the registration process • Patient Identification Manager will be alerted if duplication medical record numbers are identified • Proper name format is consistently followed • Managed care organizations are correctly identified and selected as part of the registration process, if appropriate • Timely modifications of registrations are done in order to ensure billing of encounters. • Uses independent judgment when necessary, if appropriate • Assists Practice Manager with patient complaints related to billing invoices, if appropriate • Appropriately refers patients/staff with issues/concerns to the Practice Manager • Performs Service Recovery when necessary • Seeks ways to improve quality of services provided • Has 100% of iCare, employee updates and any other in-services meetings and training as assigned • Maintains documented evidence of continuing education • Participates in multidisciplinary problem-solving groups, in-service and departmental, practice and hospital meetings as requested; may participate as PM’s proxy • Works safely and follows all safety policies; reports incidents or hazards immediately • Follows all hand hygiene protocols • Strong knowledge of departmental policies, procedures and work flows Finance • Insurance verification and precertification is performed prior to elective inpatient admission to ensure accounts are secured upon admission, if appropriate • Monitors overtime of staff and alerts supervisor, manager and employee of any overtime listed, if appropriate • For all other non-scheduled inpatients, insurance verification and precertification is performed within 24 hours of admission or by the end of the business day to perform due diligence on accounts that admitted the previous day, if appropriate • Names, dates, and times of conversations with businesses, insurances, managed care organizations, Utilization Review, and patients are documented, if appropriate • Insurance verification and precertification is performed on high dollar outpatient areas to ensure reimbursement, if appropriate • Understands the implication both clinically and financially of registration errors and the impact on the organization • Referral calls are made to PCP for Managed Care patients, if appropriate • Correct insurance is identified and selected when appropriate within the registration fields, if appropriate • Policy numbers are entered correctly into the registration fields, if appropriate • Ensures that referral authorization numbers are submitted to Patient Account Services in a timely manner and understands the implications if this is not done, if appropriate • Finishes work on time 95% of the time, avoiding overtime • Prepares billing sheets and codes invoices prior to sending to Accounts Payable, if appropriate • Collects payments (cash, co-payments, cash, checks and other forms of payment for services rendered; reconciles cash drawer/journal per EMMC policy; promptly secures/delivers the cash deposits in the designated EMMC safe or other designated area for transit to the Fiscal Services Department, if appropriate • Oversees daily revenue reports and charge reconciliation, if appropriate • Handles payroll in API and tracks time and attendance and reports to manager, if appropriate • Act in a cost-conscious manner and sets an example for others in use of office supplies Growth • Promotes services at Northern Light Eastern Maine Medical Center • Meets continuing education requirements set forth by the practice • Seeks opportunities for enhancement of skills • Assists with answering questions and directing practice staff to appropriate resources • Attends 100% of employee updates. Competencies and skills: Essential: * Achieves Results: Sets high standards for their own outcomes and seizes opportunities to engage others towards objectives. Consistently moves forward with direct actions in order to attain or exceed objectives. Manages their own time effectively to accomplish assigned tasks. Successfully prioritizes multiple projects and duties as needed. * Acts Strategic: Creates effective plans that anticipate future consequences and opportunities and is able to connect the day to day operations to longer-term objectives, shifts in the industry, and system goals. * Applies Business Acumen:Demonstrates knowledge of current and future trends that impact organizational success. Applies proven practices and business theories to get results that meet financial as well as other business goals. Recognizes opportunities for new services and products and acts accordingly, taking measured risks into consideration. Possesses a thorough knowledge of their field and independently carries out their work in accordance with professional standards of the profession. * Behaves with Integrity and Builds Trust: Acts consistently in line with the core values, commitments and rules of conduct. Leads by example and tells the truth. Does what they say they will, when and how they say they will, or communicates an alternate plan. * Demonstrates Adaptability: Learns quickly when facing a new problem or unfamiliar task; is flexible in their approach with changing priorities and ambiguity. Manages change effectively and does not give up during adversity. Capable of changing one's behavioral style and/or views in order to attain a goal. Absorbs new information readily and puts it into practice effectively. * Demonstrates Emotional Intelligence: Exhibits a high level of self-awareness, self-management, other awareness and relationship management. Conducts themselves in an empathic, appropriate way, with a sense of humor and stimulates a collaborative work environment. Is respectful of the attitudes, feelings, or circumstances of others and aware of the influence of their own behavior on them. Is aware of relevant social, political, system, and professional trends and developments and uses this information for the organization's benefit. * Effectively Communicates: Listens, speaks and writes appropriately, using clear language. Communication methods are fitting to the message(s), audience, and situation and follow-ups are regular and timely. Shows that important (non-) verbal information is absorbed and understood and asks further questions to clarify when necessary. Expresses ideas and views clearly to others and has ability to adjust use of language to the audiences' level. * Exercises Sound Judgment & Decision Making: Understands and processes complex information, which allows for appropriate and accountable conclusions. Does not react too quickly or slowly. Balances facts, goals, and potential approaches taking the appropriate criteria into account. Makes active decisions and commits oneself by communicating confidently and respectfully. * No previous experience required. * Utilizes Resources Effectively: Understands how to get the most out of available resources and uses cost-benefit thinking in decision-making and in setting priorities. Monitors and analyzes resource usage to identify and eliminate areas of waste and maximize resources. As a leader, defines targets and provides appropriate means; oversees progress and makes adjustments when necessary. Appropriately delegates work, sets clear direction and manages workflow and time. Credentials: Education: Essential: * High School Diploma/General Educational Development (GED) Working conditions: Essential: * Potential exposure to abusive and/or aggressive people. * Work with computers, typing, reading or writing. * Lifting, moving and loading 20 to 30 pounds. * Continuous sitting. * Continuous standing. * Continuous walking. Position Patient Service Rep III Location US:ME:Brewer Req ID 3933

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