Outpatient Service Representative-3

Rhode Island Hospital; Rhode Island; On-site; USD 42,000 - 54,000; Full time

Job summary

Rhode Island Hospital is seeking an administrative professional to streamline patient visits in ambulatory care. Responsibilities include preparing patient records, registration, scheduling, and co-pay collection while delivering courteous service to patients and families.

This role supports coding and billing workflows, tracks follow-up care, and generates reports reflecting scheduling activities. Proficient PC skills and strong customer-service orientation are essential.

Qualifications

• High School Diploma or equivalent.
• Knowledge of PC skills using Windows and basic software.
• Knowledge of medical billing routines for physician office practice.
• Knowledge of medical terminology, diagnosis codes, and procedure codes.
• Courteous telephone technique and good customer service skills.

Responsibilities

• Schedules patients using the hospital scheduling system and sets appointment types, clinics, and times.
• Performs pre-registration and registration; collects co-pays and provides receipts.
• Mails informational material and coordinates with outside agencies for patient information and pre-authorizations.
• Acts as outpatient center receptionist; greets patients and verifies information at the point of care.
• Handles coding/billing within department guidelines; enters codes and resolves billing issues with patients and finance services.
• Obtains and organizes medical records to ensure complete files for treatment or clinic visits.
• Prints reports using scheduling and billing systems.
• Performs duties in line with hospital mission and policies.
• Responds to inquiries by rotating into a centralized call setting.

Skills

PC skills

Medical billing knowledge

Medical terminology

Courteous telephone technique

Customer service skills

Education

High School Diploma or equivalent

Tools

Windows OS

Online billing system

Card embosser

Job description

SUMMARY:

Under the general supervision of, but according to established policies and procedures, the incumbent performs various administrative duties to expedite each patient's visit for clinical care. These duties include preparation of patient records; registration and pre-registration activities; problem resolution; appointment scheduling; and, co-payment preparation and collection. In addition, ancillary duties performed provide tracking and status of follow-up care as it pertains to specific diagnostic coding, billing/payment resolution, and generation of system reports, which reflect scheduling activities. Brown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday actions with patients, customers and one another.

In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success Factors include:

• Instill Trust and Value Differences


• Patient and Community Focus and Collaborate

RESPONSIBILITIES:

• 1. white-space:pre Schedules patients using the hospital's scheduling system. This includes establishing the appointment type, specific provider clinic, and appointment time. Schedules follow-up appointment using the on-line scheduling system. May schedule appointments for patients who need lab work, diagnostic imaging or referral to other medical providers. Refers technical/clinical inquiries to appropriate personnel. Utilizes the on-line billing system to enter diagnosis/service codes from encounter sheets. This includes accurately entering the appropriate code in the hospital's billing system.


• 2. Completes pre-registration and registration process using the on-line billing system. Verifies demographic data, insurance authorization information, co-pays and physician. Collects co-payments and provides patients with receipts. Produces registration cards using the on-line system and card embosser. Photocopies front and back of insurance card. Confirms patient eligibility with insurance carriers and obtains visit authorizations as necessary. Provides mature, quality customer service to patients, their families and/or their representatives.


• 3. white-space:pre Mails informational material to new patients in advance of scheduled appointments. As necessary, contacts agencies outside the Hospital to obtain pertinent patient information and to coordinate clinic/treatment programs. Contacts third party payors to obtain required pre-authorizations in accordance with established policies


• 4. white-space:pre Acts as an outpatient center receptionist. Makes telephone calls to patients as appointment reminders. Answers incoming calls. Returns phone calls to patients, physician offices and other medical providers such as laboratory and radiology facilities. Greets arriving patients and verifies pertinent information and physician using the online billing system. Orients patients to the specific outpatient center as a hospital-based service. Interacts effectively with patients and their family members.


• 5. white-space:pre Handles coding/billing within parameters as outlined in the department guideline. Using the on-line billing system enters diagnosis codes/service codes from encounter sheets. Verifies the appropriateness of the diagnostic code prior to entering in the billing system. Interacts with patients and Patient Financial Services in order to resolve billing issues, including denials. Appropriately refers patients to patient advocate for financial counseling.


• 6. white-space:pre Obtains and organizes medical records for use by physicians and nurses. Ensures patient's file is complete prior to treatment/clinic visit including appropriate records, lab test results and x-rays. Evaluates file prior to schedule visit and follows up with other Hospital departments to obtain missing data


• 7. white-space:pre Prints reports using both the online scheduling and billing systems.


• 8. white-space:pre Performs all duties in accordance with RIH's mission, the defined role of ambulatory care, and defined administrative/clerical rules, procedures and policies.


• 9. white-space:pre May respond to telephone callsnquiries by rotating into a centralized setting (i.e., a call room).

MINIMUM QUALIFICATIONS:

• BASIC KNOWLEDGE:High School Diploma or equivalent. Demonstrated knowledge of PC skills using the windows operating system environment and accompanying software packages. Must have knowledge of medical billing routines for physician office practice. Must also have knowledge of medical terminology, diagnosis codes, and procedure codes. Must use and have knowledge of courteous telephone technique and good customer service skills.


• EXPERIENCEix months experience coding and billing using online billing system.


• WORK ENVIRONMENT AND PHYSICAL REQUIREMENTS:Walking, sitting, standing throughout the day in clinic setting.


• INDEPEND