Providence Health & Services Patient Care Representative III - Redondo Beach in Redondo Beach, California
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Providence is calling a Patient Care Representative III (Full time/Variable shift) to Providence Medical Institute in Redondo Beach, CA.
The schedule for this position is Mon-Fri 7:30am – 6:00pm, with flexibility in start time required.
Please upload a current resume reflecting all relevant experience
We are seeking a Patient Care Representative III who will responsible for patient management, the flow of patients through the front office in an efficient and professional manner, the accurate coding of services rendered, over the counter cash management, verifying and communicating insurance and demographic information, extensive knowledge of the practice management system, including formatting, scheduling matrix, and inventory management.
Work to ensure safety, best practice, and high quality standards are maintained for the patient across the health care continuum.
Effectively with a diverse population of patients and multi-disciplinary team members. Working in an environment of constant change. Balancing the complex daily workload while providing excellent customer service.
In this position you will:
Answer phones promptly. Screens and directs phone calls appropriately. Timely response to routine inquiries. Takes accurate and complete messages (100% of the time) and forwards messages promptly and accurately
Schedule patients in a timely and accurate manner
Complete patient check-in process. This includes:
Ensure patients sign the sign-in sheet
Verify/update or has patient complete new Patient Registration Form
Collect and ensure accurate insurance and demographic information
Copy insurance card
Initial Patient Registration Form and superbill to confirm completeness of insurance information
Collect patient copayments
Complete patient checkout process. This includes:
Maximizing collections by following department policies and procedures
Reviewing the patient superbill for completeness of services rendered, diagnosis, follow-up instructions and scheduling next appointment or completing patient recall card
Completes authorizations as directed by the insurance requirements and the physician/provider. Maintains authorization log and notifies patient of receipt of authorization within twenty-four hours. Notify physician/provider within 24 hours of any denials
Maintain an orderly and pleasing work space that ensures the integrity and safety of the practice, patients and personnel
Responsible for accurate coding and batching of services rendered. Prepare paperwork, including accurate completion of Batch Summary Form (95% of the time) and submit within forty-eight hours the completed required information to the Central Billing Office
Responsible for maximizing collection of all over the counter payments due at time of service. This may include copayments, deductibles, uninsured and patient balances. Manage received cash by adhering to the department policy and procedure on cash control
Responsible for maintaining and documenting an appropriate inventory of front office supplies
Has substantial knowledge of practice management information system, can review and understand patient profile summaries, make entries to receivable program and format scheduling matrices
Responsible for timely and accurate verification of patient insurance and demographic information and ensures the communication of this information to the appropriate staff
Maintaining an orderly and pleasing work space that ensures the integrity and safety of the practice, patients and personnel
Scan and link text/images in Electronic Medical Record
Serve as liaison with employers for worker’s compensation and employer bulk and MILCM, to facilitate workflow and customer service
Responsible for completing worker’s compensation first reports and status reports
Responsible for reporting status of diagnostic/specialty services ordered by rendering physician at the site in a timely manner, as specified by supervisor
Responsible for the coordination and oversight of Employer Bulk Accounts and the work is completed timely and accurately
Responsible for completing specialty services batching accurately and timely
Responsible for “Rounding with Purpose” and being the Patient Advocate
Documentation/Information Management: Utilizes MIS systems according to policy and procedure. Appropriate care and maintenance of MIS system needs to be observed at all times
Development: Keeps abreast of department policies and procedures by positively participating in staff meeting and inservices (minimum of 8/year)
Performance Improvement: Participate in CQI and/or quality management activities as identified by supervisor
Budgetary: Responsible to use equipment and supplies efficiently and to make suggestions for cost cutting initiatives to supervisor as needed
Work with all clinical teams as a resource on care coordination of all patients of the practice, this would include the following:
Pre-visit planning workflow to ensure care completion prior to visit whenever possible. Serves as a resource to clinical staff and providers to meet quality goals by reaching out to patients, treats caregivers, physicians, NPs/PAs, visitors, patients and families with dignity and respect
Develop relationships with patients as an integral member of team by phone, portal, etc.
Provide follow-up contact with patient as indicated to ensure compliance with recommendations, medications, lab/x-ray, specialist visits, PCP visits, dieticians, CDE, etc.
Anticipate the needs of the patient populations, seeing that necessary documentation and pre-visit planning is completed or requested before patient visit
Communicate barriers to providers when patient has not kept important appointments
Coordinate many administrative aspects of the patient's care; referrals to specialists, hospitalizations, ER visits, ancillary testing, and other enabling services
Provide timely information to patients and/or family for effective care coordination and enhanced patient care team communication
Maintain accurate and timely documentation
Provide educational resources to the patient/family as appropriate as instructed by the physician or registered nurse
Participate in huddles and team meetings
Required qualifications for this position includes:
H.S. Diploma or GED
3 years recent health care experience working in a clinical setting
2 years experience with electronic medical records
2 years coordination of administrative aspects of patient care
Knowledge of ICD-9 / CPT Coding
Basic computer skills including Microsoft Windows and Office applications
Proficient computer-data entry, retrieval and report generation
Typing / keyboarding skills 45 WPM
Is involved in the resolution of urgent or time-consuming tasks that improve quality, team efficiency, and patient or office flow.
Knowledge of common safety hazards
Knowledge of HIPAA (Health Information and Portability Accountability Act) privacy and confidentiality policies to all daily activities
Analyzes problems skillfully and works with co-workers to identify areas for improvement
Demonstrates critical thinking skills using sound judgment in the coordination of patient care
Excellent written, verbal and listening communication skills
Attention to detail following detailed procedures and ensures accuracy in documentation and data.
Manages multiple priorities and time effectively and efficiently
Ability to identify and resolve problems
Ability to apply guidelines and protocols
Ability to work with diverse patients/family populations
Ability to work independently, while collaborating with other team members
Demonstrates excellent customer service while actively incorporating the Providence Mission, Standards of Behavior and Core Values into daily activities
Ability to establish and maintain effective working relationships with patients, families, medical staff and co-workers
Ability to self-motivate, prioritize and invest in a change process to improve efficiencies
Ability to work independently while collaborating with other team members
About the hospital you will serve:
Providence Health & Services is further developing its physician integration strategy. Historically, the largest asset has been Providence Medical Institute, a medical foundation that provides administrative and other support services to affiliated medical groups. Providence Medical Institute is expected to grow significantly in the next several years, bringing with it facilities, staff and physician growth to support that objective.
For information on our comprehensive range of benefits, visit:
As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.
Providence is a comprehensive not-for-profit network of hospitals, care centers, health plans, physicians, clinics, home health care and services continuing a more than 100-year tradition of serving the poor and vulnerable. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
Job Category: Patient Services
Location: California-Redondo Beach
Req ID: 272893