Patient Services Specialist
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This position is responsible for conducting daily activities of the Gulf Coast Center's Front Desk and play a key role in Revenue Cycle Management. The Patient Service Specialist is responsible for managing the daily activities of Front Office to include scheduling, registration, and insurance verification. They will collaborate with all clinical staff to ensure patient flow while providing excellent customer service. The PSS will have a knowledge of all programs at the Gulf Coast Center.
Gulf Coast Center operates under a trauma-informed approach based on the six key principles of Safety, Trustworthiness & Transparency, Peer Support, Collaboration & Mutuality, Empowerment & Choice, and Cultural, Historical & Gender issues.
Job Duties: (To be performed with or without accommodation as based on ADA requirements)
The Patient Services Specialist will be responsible for the following:
Essential Job Duties:
- Responsible for using internal messaging and email systems and to work in EHR system to manage patient arrivals for appointments with MD's or Caseworkers.
- Responsible for routing some income phone calls.
- Responsible for Front Desk Functions in the Revenue Cycle Management process
- Welcome patients and visitors, to determine the purpose of visit.
- Facilitate Patient flow and communicates any delays with patient and clinical staff.
- Preparing and reviewing patient records in Center's EHR for daily scheduled appointments to include patients accounts and amounts due by patient. Collection of patient revenues such as co-payments, patient fees, and past due balances; Applying those revenues to Patient's Account.
- Completing daily reconciliation process of cash receipts as indicated by Finance Department.
- Screening patients for demographic changes, insurance changes, searching for patients and/or registering new patients in EHR (SmartCare); closing and opening patients in episodes as appropriate.
- Collecting Insurance cards, scanning into EHR and verifying active coverage using Online web portals.
- Monitoring patient's benefits and communicating with appropriate staff when a loss or change of benefits occur for all Center Programs
- Scheduling patient's return appointments in Center's EHR. Manage daily appointment schedules to allow for work-in/ walk-in. Send/Call appointment reminder notices.
- Responsible for documentation of above patient services in EHR accurately and efficiently. May require duplicate entry due to multiple EHR's.
- Must be cross trained to provide backup assistance in completing the Financial Assessment as outlined in the Texas Administrative Code, Charges for Community Services, scheduling appointments within the Call Center if needed.
- Must have the ability to maintain a professional behavior at all times while having assertive conversations about collecting past due amounts, co-payments and late appointments, or rescheduled/missed appointments.
- Must understand and follow Center policy around Standardized Scheduling, Intake, Crisis, and non-compliant appointments. This will include knowledge about TRR authorization of services.
- Responsible for requesting photo ID to confirm client name & date of birth upon arrival for medication pick-up; determine if there are any identified, pending documentation requirements; obtain client signature on Medication Distribution Sheet; ensure staff signature on Medication Distribution Sheet in designated area for placement in EHR
- For persons other than the client presenting for medication pick-up: Responsible for receiving signed statement, including date of birth from the client authorizing release of medication to representative; representative must present photo ID.
- Will be responsible and accountable for the adherence to and promotion of the agency compliance policy and will require communication with various departments to foster, develop and continue our community partnerships as it relates to the position.
- Treat all individuals with the utmost courtesy, decency and respect.
- Provide responsive, and efficient services.
- Interact with staff, consumers, local entities and advocacy groups to provide a service that meets local needs.
- Provide highest level of Customer Service for both internal and external customers.
- Required to report personnel leave; flex time and emergency leave to assigned supervisor.
- Strict adherence to the professional, ethical, and legal requirements set forth in GCC's Business Code of Conduct as well as the Corporate Compliance Plan.
- Consistent adherence to the Center's Dress Code.
- Consistent adherence to Center safety guidelines and expectations.
- May be required to travel within Brazoria and Galveston Counties.
- Out of region travel may be required to attend trainings.
- Must maintain a clear driving record and driver's license in accordance with our Driver Policy.
- Requires current Texas Driver's License, reliable transportation and must maintain current auto liability insurance.
Non-Essential Job Duties:
- Receives direct supervision from Patient Services and Benefit Manager
- Requires a high school diploma or equivalent
- Prefer College degree
- Requires 2 years experience in Healthcare Insurance.
- Managing front office type duties described above.
- Healthcare Insurance related tasks.
- Knowledge of Customer Service principles and practices.
- Requires experience in scheduling for busy office setting.
- Prefer experience in Mental Health, Substance Use Disorders, and/or Intellectual Disability field.
- Requires experience in working successfully within a clinical team approach.
- Prefer 5 years experience in Healthcare Insurance with knowledge of Social Security Programs.
- Proficiency in client insurance related tasks
- Excellent organizational skills
- Excellent time management, multi tasking, critical thinking , and accuracy skills
- Must have excellent communication skills to display self confidence and a positive attitude when working with Patients, Family members, outside agencies and team members/co-workers.
- Demonstrated ability to work within Multiple Electronic Health Record (SmartCare and CMBHS), as well as, Managed Care and Commercial Insurance portals to include, TMHP.
- Must be self motivated.
- Can work effectively in a Team environment and prepare busy Outpatient Clinics for daily operations.
- Proficiency in insurance related tasks
- Work in Electronic Health Record (SmartCare and CMBHS), as well as, Managed Care and Commercial Insurance portals to include, TMHP.
- Ability to express self clearly and effectively, orally and in writing.
- Requires ability to work within a team approach.
- Requires proficiency with computer skills, programs and email.
- Work will be performed in the Office setting.
- May require varied work hours depending on need of clients.
- Out of region travel may be required to attend trainings.
- May require travel to various locations within Brazoria and Galveston Counties. Requires current Texas Driver's License, reliable transportation safe and current with all state requirements, and liability insurance.
- Assist supervisor when requested to complete special projects and complete all assignments within a time frame negotiated with the supervisor. Completion of other duties as assigned by supervisor as it relates to the program and position.
Job Related Physical/Mental Requirements & Environmental Conditions:
- Ability to transport, adjust and/or move items up to 45 lbs.
- Ability to ascend/descend stairs.
- Ability to remain in a stationary position for long periods of time.
- Ability to handle objects.
- Ability to operate office equipment.
- Ability to move around within an office setting and/or other locations as needed; may include ability to bend/twist, kneel/stoop and/or reach for items.
- Ability to detect and write effectively.
- Ability to hear (with or without aid).
- Ability to have visual acuity to operate a motor vehicle and observe objects within work setting.
- Ability to accept constructive criticism.
- Ability to maintain regular attendance.
- Ability to understand, communicate and comprehend accurate information with others in English.
- Ability to reason and analyze effectively.
- Ability to solve practical problems as it relates to position.
- Required to pass and maintain all Center mandated trainings.
Work Site/Environmental Conditions:
- Ability to work alone.
- Ability to work closely with others.
- Ability to work long and/or irregular hours.
- May be subjected to hostile environment.
- May be subjected to both inside and outside environmental conditions.
- Subject to standard noise levels within working environment.
- Travel by motor vehicle, van, bus or plane may be required.
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