Patient Service Representative

1. Applies the step-by-step AWAKEN process to consistently fulfill our patients’ needs and help the Dental Department maintain excellent Patient Satisfaction scores. AWAKEN: Anticipate, Welcome, Appreciate, and Keep it real, Excellence and Never.
2. Answers telephones, routes call, takes messages and provides routine information to patients or staff. Responds to all telephone inquiries in a timely and courteous manner.
3. Provides guidance and direction to visitors and patients. Calls for transportation as necessary.
4. Verifies patient’s demographic and personal information and enters them in the appropriate EHR program.
5. Verifies insurance benefits and eligibility by using eligibility portal in Nextgen and MediCal.
6. Schedules appointments by telephone and in person; follows up on failed and cancelled appointments. Performs the 24 or 48-hour patient appointment reminder calls or updates status of text message calls into Dentrix. Contacts patients if their provider is unavailable on any given day and documents any patient cancellations. Calls patients to backfill any open appointment slots.
7. Covers for the Patient Service Lead when on leave and performs any task required from a Patient Services Lead.
8. Responsible to communicate equipment and office maintenance as needed.
9. Must collect patient payments, co-payments and deductibles and generate accurate receipts for dental services rendered. Utilizes POS machine for Credit Card payment processing. Collects all daily payments, balances against Dentrix reports, processes the needed documentation and personally delivers fund to Lead.
10. Presents treatment plan estimate and makes financial arrangement with patient at time of consultation based on the patient’s insurance coverage. Generates financial contracts, explains, and collects signatures from all private and sliding fee scale patients. Processes all financial contracts and submits them to the billing department accordingly.
11. Effectively identifies patient grievances, follows established protocols to resolve or determines escalation level and need to refer to supervisors.
12. Performs follow up on unpaid accounts during the check-in or check out process to ensure collections report are within the organization’s expectations of 95% or above.
13. Keeps abreast of all changes via web and/or by leadership with regards to changes in MediCal coverage for dental service.
14. Responsible for creating a patient record for all new patients.
15. If needed, responsible for assisting patients in the filling out of registration and Medical History forms.
16. Responsible for organizing new patient charts and ensures that all needed documents are signed by patient.
17. Responsible for sorting correspondence and referrals, etc. identify with label and scan into document center in EHR system.
18. Maintain privacy of all patients, employee and volunteer information and access such information only on a need-to-know basis for business purposes. Comply with all HIPAA regulations regarding corporate integrity and security obligations.
19. Assures a signature on all reports, correspondence, referrals, etc. from the appropriate provider before filing the chart.
20. Assists patients in completing a record release/request form as needed.
Other Responsibilities
1. Maintains an adequate inventory of forms, clerical supplies, and Xerox paper.
. Maintains established departmental policies and procedures, objectives, quality assurance program, safety, environmental and infection control standards.
3. Participates in educational programs and in-services meetings.
4. Attends meetings as required.
5. Attends morning or afternoon huddles as directed by Manager
6. Performs other related duties as assigned or requested. Supervisory Relationship Reports directly to PSR Lead and Dental Manager
Requirements
Education Minimum: High School or equivalent.
Experience Minimum 1 year experience in a general office setting. Preferred In a dental setting.
Equipment Used Multi extension telephones. Personal computer, Printers, Fax, and POS Machine.
Technical Knowledge: Knowledge of Medi-Cal, Medicare, managed care plans, third party rules and regulations and insurance agreements. Claims processing, and daily operations of dental office, OSHA regulations and safety procedures.
Skills: Other Bilingual (English/Spanish). Good oral and written communication. Experience with Dental Terminology, NextGen, Dentrix and Windows Office systems preferred. Typing of a minimum of 35 wpm. Dental records filing and dental terminology. Effort required
Physical Activities Lifting of approximately 25 lbs.
Working Traits Verbal ability for accurate and tactful explanations.
Working Condition May be required to work some evenings and/or Saturdays.