Position: Patient Service Representative

 Location: Nurse Manage Primary Care Clinic-STAR Campus, Health Sciences Complex

Hours:  M-F 24-29 hours weekly   

Context of the Job:

The Patient Service Representative performs specialized duties including processing, researching, analyzing, compiling, and maintaining administrative records and accounts. The successful applicant for this position will be detail-oriented, flexible, and responsible for serving as a backup for clinic office operations. Operating with minimal supervision, the Patient Service Representative is expected to demonstrate initiative, strong problem-solving skills, and consistent discretion and independent judgment when addressing clinic-related matters and operational needs.

The applicant must be able to communicate effectively with patients, clients, families, clinicians, insurance companies, and other individuals in the community using a variety of communication styles. The Patient Service Representative greets and responds to patients, assists with documentation, gathers and maintains personal information and compliance. Duties include collecting payments, processing and verifying insurance details, obtaining medical history, and keeping patients informed and updated throughout various aspects of their care and clinic experience.

The Patient Service Representative will be required to demonstrate schedule flexibility to support operational needs. The position requires the ability and willingness to travel between UD Health clinic locations based on business needs and to provide coverage and operational support at the various clinics. This may include adjusting work locations and schedules to support patient volume, staffing needs, and continuity of clinic operations.

Preferred applicants will possess knowledge of medical billing, insurance verification, and/or financial processes, as well as the ability to work independently, prioritize competing responsibilities, and adapt effectively to changing clinic needs.

Major Responsibilities:

Responsible for obtaining or verifying information of clinic management data and resolving problems relating to medical and financial procedures and deadlines, while maintaining excellent client service and patient experiences.

• Research and respond to routine and non-routine inquiries from patients, medical facilities, billing companies/organizations, and insurance companies.
• Review, verify and process financial and non-financial documents and payments.  Review patient accounts, identify delinquent accounts, and collect due amounts.
• Verify patient’s insurance coverage and collect co-payments.
• Process credit card payments and balance daily cash deposits.
• Investigate and direct patient inquiries or complaints to appropriate medical staff members for resolution.
• Help maintain schedule utilization and conduct appropriate scheduling.
• Check out patients upon appointment completion, schedule for future appointments, follow–up on self-pay balances and questions.
• Assist with achievement of new patient goals by discussing positive qualities of the Practice during check-out. Demonstrate care, enthusiasm, and empathy. Understand practice goals and new patient processes.
• Perform general office duties, such as document preparation, scanning, and indexing.
• Enter and update insurance information.
• Maintain confidentiality of Patient PHI and any other related information according to HIPAA Privacy Practices. Maintain clean, neat work areas.
• Applies intermediate-advanced skills appropriate for the position or specialization, including, but not limited to, insurance authorizations and verifications.
• Utilizes word processing, spreadsheet, and database computer applications, including electronic medical billing software.
• Works under limited supervision with clearly defined procedures.
• Welcomes patients, visitors, faculty, and guests to the Clinic.
• Other related duties as assigned.

Qualifications:

• High school diploma or GED and two to three years of experience.  Experience in a health or educational setting preferred, or an equivalent combination of education and experience.
• Experience in office operations or customer service.  
• Experience in data collection, which includes collecting, compiling, and maintaining data from multiple sources such as files, records, databases, customers, staff, or others.
• Sensitivity to confidential matters and patient needs is vitally important. General knowledge of HIPAA guidelines is required. 
• Experience with effective time management skills and prioritizing.

Special Requirements:

• Must be flexible with work schedules and clinic locations based on patient and staffing needs.
• Must be willing to travel between UD Health clinic locations as needed.
• May need to adjust schedules or work locations to ensure smooth clinic operations.