Patient Services Rep II-Ambulatory care center

Nemours; Milford (CT); On-site; USD 32,000 - 42,000; Full time

Job summary

Nemours is seeking a Patient Service Representative II to support outpatient visits at our Milford, CT location. The role requires attention to detail in patient check-in, verification of demographic and insurance information, and proactive communication with families using the AIDET approach.

The position includes processing co-pays, referrals, and forms, as well as assisting with appointment scheduling and end-of-day reconciliation. Strong clerical skills and HIPAA awareness are essential.

Qualifications

• High School diploma or equivalent is required.
• 3–6 months of job-related experience.
• Computer/typing skills are required.
• Clerical experience in a physician's office is preferred; EPIC experience preferred.

Responsibilities

• Greet patients and families and use AIDET protocol at the start of each interaction.
• Complete check-in, visit, and check-out tasks and related pre-visit activities.
• Verify demographic and financial information; scan insurance cards and collect co-pays.
• Schedule follow-up appointments and reconcile payments at end of shift; complete end-of-day reports.
• Communicate with clinical staff to update on waiting patients and clinic status.

Education

High School diploma or equivalent

Tools

EPIC experience

Job description

Nemours is seeking a Patient Service Representative II

Work hours are Monday through Friday between 7:30 a.m. and 6:30 p.m. There may be a future requirement to work a minimum of six Saturdays per year according to business needs.

Provide service excellence to each patient and family by performing and completing designated business processes associated with an outpatient visit. At each outpatient visit, complete processes in an efficient fashion, ensuring that the patient and family are prepared for their outpatient appointment in a timely fashion. Also, ensure that all demographic and financial information is accurately verified in advance of the patient visit, and monitor the waiting room and work environment to ensure patient safety and high service levels.

Participate in Nemours programs for continuous quality, performance, and service improvement and work with department management to improve the services provided, through a team-based approach.

ESSENTIAL RESPONSIBILITIES

• Greet and communicate with each patient and family at the start of their outpatient visit and at each interaction using AIDET protocol (acknowledge-introduce-inform about duration-explain-thank).
• Accomplish tasks that are a part of the Nemours' outpatient appointment business functions prior to and at the time of appointment check-in, visit and check-out. Duties may be specific to each outpatient location. All general duties include but are not limited to:
  • Prepare for scheduled patient visits <=48 hours prior to the appointment of each patient using protocol established for each location/service.
  • Make confirmation calls that are not completed by Televox to ensure all visits are in "confirmed" status prior to visit or per Department protocol.
  • Confirm authorization and/or collect referrals for the days' visit. Notify Pre-Registration and Authorization Department of visits scheduled same day, as necessary. Fax hard copy referrals to the PRAG department within 24 hours of receipt.
  • At the time of patient check-in, while maintaining patient confidentiality and all aspects of HIPAA,:
  • confirm all patient personal demographic information.
  • confirm patient identification with two identifiers as approved by Nemours.
  • confirm legal guardianship
  • confirm referral information for patient visit; if applicable
  • prepare, complete and/or collect consents and all other required documents
  • scan insurance cards and other important documents
  • collect and post co-pays and past due balances
  • achieve Registration Accuracy percentage of => 95%
• Schedule follow up appointments (utilizing iGuide to determine participation, if appropriate)

Responsible for MyNemours sign ups and facilitation activations. Throughout shift, regularly communicate with clinical staff in the assigned work area regarding the status of waiting patients, particularly those who have been waiting more than ten minutes and then with waiting patients/families to ensure they have status updates on their appointment. Communicate clinic status to families in the waiting area using the principles of AIDET. Contact manager with problem situations or when assessment is that service recovery is necessary. Accurately reconcile payment collections at the end of each shift, as per Cash Collections Policy, and complete End of Day (EOD) Reports including DCRF and LDCRS. Complete assigned work queues daily. Maintain computer and electronic system competency including but not limited to processes for: scheduling, appointment cancellations and order entry for clinical system, use of Iguide, EOD status changes, work queue processing, linking referrals, posting "other" payments, use of scanner device and electronic insurance verifications. Maintain inventory of clerical supplies and ensure the work environment and outpatient waiting room is in an orderly and clean condition to ensure patient safety and security. Complete EOD (End of Day) Report. Other duties that may be assigned by manager/supervisor may include: Schedule and cover the phones between check-in and check-out duties as necessary or determined by supervisor. This responsibility may include scheduling: incoming calls as an agent for automated call distribution (ACD) services maintaining in-basket regarding clerical functions from Online Scheduling, MyNemours and office communication. Recall patients from waitlist follow-up calls upon discharge from inpatient units clinic cancellations.

POSITION QUALIFICATIONS

• High School diploma or equivalent
• Minimum of 3-6 months of job related experience
• Computer/typing skills required
• Clerical experience in a physician's office preferred; EPIC experience preferred

About Us

Nemours Children's Health is an internationally recognized pediatric health system serving more than 1.7 million patient encounters each year. We deliver care across six states through two freestanding children's hospitals - Nemours Children's Hospital, Delaware and Nemours Children's Hospital, Florida - along with a network of more than 80 primary, urgent, and specialty care practices and more than 40 hospital partnerships.

Backed by the Nemours Foundation and Alfred I. duPont Trust, our $1.7B nonprofit system is dedicated to improving children's health through clinical care, research, education, advocacy, and prevention. Our Whole Child Health approach focuses equally on prevention and treatment, partnering with communities to help every child thrive.

Inclusion and belonging guide our strategy and growth. We are committed to culturally relevant care, reducing health disparities, and fostering an environment where every associate, patient, and family feels supported and valued.

Learn more at Nemours.org .