Outpatient Service Rep

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
• 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

Schedules patients using the hospital's scheduling system. This includes:

• Establishing the appointment type
• Specific provider clinic
• Appointment time

Schedules follow-up appointments using the online 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 online billing system to enter diagnosis/service codes from encounter sheets. This includes accurately entering the appropriate code in the hospital's billing system. Completes pre-registration and registration process using the online 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 online 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. 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. 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. Handles coding/billing within parameters as outlined in the department guidelines. Using the online billing system, enters diagnosis codes/service codes from encounter sheets. Verifies the appropriateness of the diagnostic code prior to entering it 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. Obtains and organizes medical records for use by physicians and nurses. Ensures the patient's file is complete prior to treatment/clinic visit including appropriate records, lab test results, and x-rays. Evaluates file prior to scheduled visit and follows up with other Hospital departments to obtain missing data. Prints reports using both the online scheduling and billing systems. Performs all duties in accordance with RIH's mission, the defined role of ambulatory care, and defined administrative/clerical rules, procedures, and policies. May respond to telephone calls/inquiries 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

EXPERIENCE:

• Six months experience coding and billing using an online billing system

WORK ENVIRONMENT AND PHYSICAL REQUIREMENTS:

• Walking, sitting, standing throughout the day in clinic setting

SUPERVISORY RESPONSIBILITY:

• None

PAY RANGE

$21.26-$21.81

LOCATION

East Greenwich-1454 South County Trail - 1454 South County Trail East Greenwich, Rhode Island 02818

WORK TYPE

M-F 830-5

WORK SHIFT

Day

DRIVING REQUIRED

No

UNION

International Brotherhood Teamsters

Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment.