Lead Patient Support Representative

Appalachian Mountain Health; Northern (KY); Hybrid; USD 36,000 - 56,000; Full time

Job summary

Appalachian Mountain Health is seeking a Front Office Administrator to guide the front office team in delivering efficient patient check-in, accurate data entry, and responsive customer service. You will monitor daily performance, manage co-pays and balances, and coordinate with the billing team to resolve account questions.

Knowledge of Practice Management systems and EHR is preferred. The role requires at least two years’ experience in a primary care or public health setting and a High School

Qualifications

• High School Diploma or GED required.
• At least two years of experience in a primary care or public health setting functioning at the full extent of her/his training
• Experience with Practice Management systems and EHR

Responsibilities

• Coordinate and manage the activities of front office team members engaged in checking in patients and performing general administrative tasks.
• Monitor daily performance of front office team members ensuring that all check-in protocols are followed and patient information is accurate.
• Hold daily huddles to prep for next day schedule and review balances, copays, and insurance issues.
• Ensure co-pays and balances due are collected at check-in and provide receipts.
• Notify billing department of outstanding balances and questions about accounts or payment plans.
• Prepare payment plans for patients at time of service.
• Assess eligibility for sliding fee discount program and explain responsibilities to patients.
• Advise patients on billing statements and refer questions to AMH’s revenue cycle vendor.
• Provide information about AMH locations, hours, insurance participation and SFDP to patients and providers.
• Maintain confidentiality and comply with HIPAA.

Education

High School Diploma or GED

Tools

Practice Management systems

EHR

Job description

Description

Summary of Responsibilities

Responsible for guiding the front office team to ensure positive business outcomes. Duties include focusing on the constant improvement and maintenance of customer service, process efficiency and effectiveness, lowering error rates, improving TOS payments, and establishing and maintaining daily protocols.

Key Accountabilities

• Coordinate and manage the activities of front office team members engaged in checking in patients and performing general administrative tasks as directed.
• Monitor daily performance of front office team members ensuring that all check-in protocols are followed by every team member all the time, ensuring patient ID, all demographics are updated and insurance cards are asked for at every visit and entered correctly. The only acceptable goal is 100% verification of all insurances and coverage prior to the patient setting foot in the practice and is entered correctly in the system.
• Hold daily huddles to assist with prepping for the next day schedule by looking at patient’s accounts for balances, copays, problems with insurance and demographics.
• Ensure co-pays and any balances due are paid at TOS while checking the patient in, and providing patients with a receipt of payment.
• If no copay is received a “Billing Alert” comment needs to be added as to why. Notify the billing department regarding patients who have outstanding balances, financial questions, questions regarding their account, and questions about payment plans.
• Prepare payment plans for patients at time of service and notify billing department.
• Monitor Family Planning Medicaid and ensure the waiver is being signed at every visit if it is not related to family planning.
• Meets reasonable benchmarks set by Revenue Cycle Manager regarding the error rate found with patient demographics and insurance.
• Meet with the Revenue Cycle Manager monthly and relay pertinent information to front office team members timely.
• Checking patients in and out, which includes collecting and entering or verifying patient demographic information such as insurance and/or sliding fee discounts at each appointment
• Scanning and organizing patient documents in the Practice Management (PM) system or Electronic Health Record (EHR) as appropriate
• Assessing patient eligibility for the sliding fee discount program (SFDP) and clearly communicating responsibilities of the patient as part of the SFDP (e.g. providing documentation of income)
• Assessing charges, including past due balances and collection of fees (e.g. co-payment, co-insurance, point-of-care incentive)
• Referring patients with questions regarding billing statements to AMH’s revenue cycle vendor
• Assessing accuracy and completeness of medical record requests from patients, providers and third parties, scanning requests into the EHR and assigning requests to AMH’s medical records vendor
• Providing AMH organizational information such as location of practices, hours of operation, insurance participation and SFDP to patients, providers and third parties
• Actively participating in and supporting quality improvement practices.
• Maintaining confidentiality and complying with all aspects of the Health Insurance Portability and Accountability Act (HIPAA)
• Making reminder calls for next-day appointments and informing patients to bring any necessary items, including photo identification, co-payment and current medications
• Assisting clinical staff with patient referrals for specialty care
• As appropriate based on skill set, providing language interpretation to patients appropriate to the front desk role and translating written and web-based documents
• As appropriate based on education and skill set, assisting the clinical team as a Medical Assistant.

Preferred Qualifications

• Experience working with racially and ethnically diverse populations, low-income populations and people experiencing homelessness
• At least two years of experience in a primary care or public health setting functioning at the full extent of her/his training
• Experience with Practice Management systems and EHR

Education & Experience

High School Diploma or GED required.

• At least two years of experience in a primary care or public health setting functioning at the full extent of her/his training
• Experience with Practice Management systems and HER.

Requirements

Preferred Qualifications

• Experience working with racially and ethnically diverse populations, low-income populations and people experiencing homelessness
• At least two years of experience in a primary care or public health setting functioning at the full extent of her/his training
• Experience with Practice Management systems and EHR

Education & Experience

High School Diploma or GED required.

• At least two years of experience in a primary care or public health setting functioning at the full extent of her/his training
• Experience with Practice Management systems and HER

Physical Requirements & Work Environment

Seeing: Must be able to read head written and printed material, as well as use computer, fax machine, Xerox machine and other medical equipment in accordance with specialty. Hearing: Must be able to hear well enough to communicate with coworkers and others. Good hearing is necessary to receive detailed information through oral communication and to make fine discriminations in sound. Sitting: Must be able to sit for the majority of the work shift while answering telephone and communicating with others. Standing/Walking/Mobility: Must be able to stand intermittently and be capable of walking on hardwood and linoleum floors with concrete underpayments. Must be able to walk between various clinical areas and departments. Fingering/Grasping/Feeling: This position requires manual and finger dexterity and eye-hand coordination for easy and skillful use of hands when working with and performing normal office duties and responsibilities.

Work Environment Fast paced work environment the noise level in the work environment is usually moderate.

DISCLAIMER The above duties and responsibilities are essential job functions, subject to reasonable accommodations. All job requirements listed indicate the minimum level of knowledge, skills and/or abilities deemed necessary to perform the job proficiently. This job description is not intended to be construed as an exhaustive statement of duties, responsibilities, or requirements. Employees may be required to perform any other job-related instructions, as requested by their supervisor, subject to reasonable accommodation.