Patient Service Representative

Spectrum Orthopaedics was recently named the winner of the Best of the 207 Orthopaedics award!
Company Overview
Spectrum Healthcare Partners is Maine's largest multi-specialty, physician-owned and directed professional organization and is comprised of over 200 physicians practicing in the areas of anesthesiology, orthopedics, pain management, pathology, radiation oncology, radiology, and vascular & interventional services. Spectrum provides services at many of Maine's hospitals throughout the state and in eastern New Hampshire.
Hours: Monday - Thursday, 5:45am - 2:15pm; Friday 8:00am - 4:30pm
POSITION SUMMARY
Position is responsible for performing a variety of front-office functions including check-in, check-out, time of service collection, charge reconciliation and basic pre-authorization tasks to provide support/guidance to patients, office staff, physicians, advanced practice providers and physical therapists. Represents the practice in a professional, courteous manner while receiving patients into the practice.
ESSENTIAL FUNCTIONS
• Greets each patient as they enter the practice in a professional, caring manner and is warm in welcoming patients and vendors.
• Performs patient check-in/check-out process with all patients. Review's patient chart to determine what registration information is needed from the patient at time of check-in. Ensures patient records are accurate and up to date including patient name, address, date of injury, payer information, etc. by verifying existing information or entering updated data into the computer system.
• Collects copays and outstanding balances at the time of service. Performs daily payment reconciliation.
• Answers incoming internal and external calls.
• Utilizes electronic health record for messaging to/from clinical staff.
• Enters patient information into practice management system from faxed referrals, phone or email and schedules appointments per clinical protocol.
• Schedules outside diagnostic testing and secures authorization when required by insurance as directed by physician or advanced practice provider.
• Performs Pre-Authorization tasks including managing ongoing authorizations for future visits when required by insurance.
• Manages incoming faxes and other documents including but not limited to disability forms, referrals, and medical record requests.
• Scans medical documentation and other required documents into electronic health record or other document imaging system(s)
• Performs insurance verification as appropriate to ensure accurate billing to appropriate insurance for patient encounter(s).
• Maintains open communication with clinical staff to minimize interruptions to the providers' schedules.
• Collects all charge slips, reviews for accuracy and completeness. Reconciles charge sheets against schedule to ensure appropriate billing. Returns charge slips to clinical staff if they do not have the necessary information or if there are any discrepancies.
• Prepares daily charges and payments for transfer to Portland office, when applicable.
• Ensures the waiting area is presentable. Notifies Facilities of any specific needs or concerns to ensure a pleasant and safe experience for all staff, visitors and patients.
PRIMARY RESPONSIBILITIES
• Collaborates with clinical staff, Patient Accounts and other key members of staff/leadership to answer all patient questions and concerns
• Strives to maintain positive patient relations by handling problems and complaints in a professional, confidential manner
• Provides coverage for other front desk locations as needed
• May perform charge entry functions when necessary and as back up to Portland office
• Opens and distributes daily mail.
• Maintains patient confidentiality per state and federal and company regulations
• Attends meetings, as assigned, and participate in educational activities to keep skills up to date
• Demonstrates professionalism always
• Is proactive in identifying, reporting and participating in the resolution of any potential or actual patient safety issues
• Keeps abreast of current issues involving patient care or practice issues by attending and participating in department, team and practice meetings
• Displays cooperative behavior and interacts positively and effectively with others to promote a team environment
• Performs other duties necessary to maintain the overall efficiency and continuity of the clinic
• Support the Company's Vision and Values
QUALIFICATIONS
• High school degree or equivalent.
• Experience in a medical office or similar role in health care organization/ environment helpful
• Strong customer service skills
• Ability to work independently and as part of a team
• Excellent communication and interpersonal skills, with the ability to interact with all internal and external customers in a professional and caring manner
• Proficient computer skills including Microsoft Office
• Knowledge of medical records helpful
• Ability to complete work in a timely, accurate and thorough manner
• Ability to maintain confidentiality
PHYSICAL DEMANDS / WORK ENVIRONMENT
• Operation of various office equipment; fax machine, telephone & voice mail system, stationary/lap top computer, scanner, e-mail system, cell phone, pager, and copier - data entry and typing
• Light lifting of paperwork, folders or other general record keeping materials
• Occasional travel amongst company locations (for coverage)
• Lifting of mail bins and boxes up to 30 lbs.
• May be required to sit or stand for extended periods of time
• Occasional reaching, bending
BENEFITS AND PERKS
• Health Insurance (80% company paid)
• HSA Match ($3000 family plan / $1625 individual plan)
• Dental & Vision Insurance Plans
• 401(k) Match and Profit Sharing Plan
• Life and Accidental Death and Dismemberment Insurance
• Long-term Disability Insurance
• Short-term Disability Insurance
• Generous paid time off
• Voluntary, Employee-Paid Benefits
• Medical Reimbursement Plan
• Dependent Care Plan