Patient Support Specialist – HHC
Summary: The Patient Support Specialist will provide advanced support services in Front Desk and Registration operations that support and enhance participants’ access to primary care and other services within Heartland Health Centers. The individual in this position will handle complex support services including, but not limited to, collections, audits and reporting. Individual accountabilities and work volume will be established through the development of annual Success Objectives, within the framework outlined below.
Essential Duties and Responsibilities:
- Provides front desk administrative support in Heartland Health Centers. Registers and assesses participants for program eligibility and screens participants for other social service needs or benefits and entitlements services.
- Performs operator functions, answers and accurately directs incoming calls from patients, community organizations, medical organizations, and other external parties
- Educates participants regarding patient responsibilities, services, sliding fee scale, patient rights, grievance policy and confidentiality.
- Generates and updates Program Participation Form and updates participant information as assigned.
- Collects participant financial assessment documentation prior to assigning sliding fee scale discount. Screens participants for other social service needs or benefits and entitlements services.
- Maintains thorough understanding of medical coverage and third party liabilities, inclusive of Medicaid and Medicare. Verifies and updates third party insurance.
- Maintains a strong familiarity with CPT codes and determines amount needed at co-pay based on service rendered. Accurately assesses, explains, and collects co-pays and issues receipts to participants.
- Generates daily and/or weekly reports of collection data. Maintains accurate daily log of co-pay activity and forwards to Billing Department as assigned.
- Makes internal and external appointments on participants’ behalf and makes general referrals to other agencies as needed. Assesses and engages participants in case management services internally or externally.
- Coordinates patient registration activities with Front Desk, Case Management and Billing Department.
- Possesses strong and effective communication skills and assists in coordination of interpretation services for participants as needed.
- Performs moderate to high volume of data entry. Assists with incoming and outgoing mail, and sorts, distributes and logs mail for participants accordingly.
- Conducts quality assurance activities to insure accuracy of program participant data and troubleshoots patient flow issues.
- Other duties may be assigned.
Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Education and/or Experience: High School Diploma and three years of related experience or Associates degree and one year of related experience. Prior experience in a healthcare related field or social service agency preferred.
- Certificates, Licenses, Registrations: Certificate in medical billing, medical office assistant, or a related field preferred.
- Language Skills: Proficiency in a second language may be required. Excellent written and oral communication skills.
- Competencies: Ability to use computers to tabulate and analyze data and electronic technology to receive, organize, prioritize, and transmit information. Comprehension of and appropriate use of medical terminology, new developments in the health care delivery system, application of third party payer guidelines and concepts related to quality assurance measures. Ability to implement organization policies and procedures and maintain compliance with established risk management and safety procedures. General knowledge of medical record keeping and accounting, medical office practices, patient relations, and medical law, ethics and federal and state health care regulations.
Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- While performing the duties of this job, the employee is regularly required to talk and hear.
- The employee is frequently required to stand; walk; sit; use hands to finger, handle, or feel and reach with hands and arms.
- The employee is occasionally required to stoop, kneel, climb or crawl.
- Specific vision abilities required by this job include close vision and ability to adjust focus.
- The employee must occasionally lift and/or move up to 10 pounds.
- Unrestricted ability to provide physical restraint.The employee must occasionally lift and/or move up to 25 pounds. Unrestricted ability to provide physical restraint.
Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- The noise level in the work environment is usually moderate
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