Patient Service Rep- Rochester Primary Care

Wentworth-Douglass Hospital, an affiliate of Mass General Brigham, is committed to supporting patient care, research, teaching, and service to the community. We place great value on being a diverse, equitable and inclusive organization as we aim to reflect the diversity of the patients we serve. At Mass General Brigham, we believe in equal access to quality care, employment and advancement opportunities encompassing the full spectrum of human diversity: race, gender, sexual orientation, ability, religion, ethnicity, national origin and all the other forms of human presence and expression that make us better able to provide innovative and cutting-edge healthcare and research.

Wentworth-Douglass Hospital remains among the nation's top hospitals for patient experience as a recipient of the Healthgrades 2021 Outstanding Patient Experience Award for the eighth consecutive year. Wentworth-Douglass Hospital is renowned as one of the largest acute care hospitals in the Seacoast region of New Hampshire and Southern Maine. At Wentworth-Douglass, we value people who contribute to patient-centered care that enhances community health; we recognize and reward those who share our values and transform our patients' lives. We invite you to explore opportunities, cultivate community wellness and professional growth.

The PSR Lead provides positive, effective and exceptional customer service that supports departmental operations. Answering, screening and routing phone calls. Check-in and check-out duties as well as diagnostic and lab order processing. Demonstrate high level problem resolution skills. Performs Check-In duties in the practice. Performs Check-Out duties in the practice. Performs referral, diagnostic, and lab orders processing duties in the practice. Performs administrative duties in the practice. Medical Records filing and related tasks. Works to improve Press-Ganey patient satisfactions scores. Other general duties as assigned/directed.

1. Performs Check-In duties in the practice

a. Receives and welcomes all patients into the practice in a manner that is consistent with WHP service expectations and the Language of Caring program as outlined in support of patient satisfaction. Appropriately refers patient to the proper party within the office. Verifies patient using two patient identifiers.

b. Verifies all patient demographic and insurance related insurance at each visit and ensures that all data is entered in the system in an accurate and timely manner per any established protocol.

c. Ensures all required disclosure and registration forms are current and maintained in the patient's record as required per any established policies and procedures.

d. Collects patient co-pays and self-pay balances from across Wentworth Health Partners. Accurately posts payments to patient accounts.

e. Performs insurance verification per any established Wentworth Health Partners policies and procedures. Completes electronic practice management (PM) tasks associated with insurance verification.

f. Enrolls patients to the Patient Portal and responds to Patient Portal inquiries per any established policies and procedures.

g. Coordinates requests for interpreter services, documents and completes declination, if applicable.

h. Updates ACO First Visit Notification Date.

i. Ensures active insurance is attached/created for each encounter.

j. Receives, forwards and documents all messages and triaging calls for urgent information or services.

2. Performs Check-Out duties in the practice

. Receives and welcomes all patients to check-out in a manner that is consistent with WHP expectations and the Language of Caring. Verifies patient using two patient identifiers.

a. Schedules follow-up appointments as indicated by the provider including checking for future appointments to ensure no duplication.

b. Generates patient plan at check-out completion. Uploads automatically to Patient Portal - and/or prints and provides to patient.

3. Performs referral, diagnostic, and lab orders processing duties in the practice

. Processes all referrals/Diagnostic/Lab orders, including electronically in those practices utilizing an Electronic Health Record (EHR), and ensures that specialist offices receive relevant notes, labs and other testing results as applicable. All forms that are required by a specialist's office will also be completed and sent. Documentation should be transmitted electronically whenever possible.

a. Ensures compliance with all necessary insurance carriers' pre-certification requirements by forwarding to Financial Clearance.

b. Ensures appropriate forms are submitted to centralize scheduling for outpatients procedures.

c. Runs medical necessity checks on all labs and diagnostics, per protocol, and has the patient sign an ABN as needed.

d. Possess strong knowledge of HMO, PPO, exchange programs, managed care and other third party insurers.

e. Understands financial services and self-pay resources and provides patient with information as needed.

f. Instructs patient of proper preparation for procedures if applicable.

4. Performs administrative duties in the practice

. Collaborates with clinical staff and notifies patient of any appointment delays.

a. Answers the telephone per customer service standards. Reviews outstanding diagnostic and referral orders.

b. Responds to emergencies and summons the appropriate personnel.

c. Greets and acknowledges visitors upon arrival consistent with service standards and the Language of Caring and assists as appropriate.

d. Performs chart prep process - per established protocols.

e. Provides cross-coverage for other practice staff members as needed. Works effectively with other practice staff to manage workflow as a team.

f. Demonstrates technical ability to learn various new software and web based applications, and how to effectively interface between programs.

g. Provides administrative support with different projects and initiatives within department.

h. Works collaboratively with patients, staff, providers and managers to determine needs and solve problems.

i. Files, faxes, collates, and photocopies material as required (including all electronic documentation).

j. Mentor new PSR staff to roles and responsibilities.

5. Medical Records filing and related task

. Maintains file system according to WHP and department standards. Collaborates with clinical staff to perform tasks related to non-interfaced diagnostics and order management of incoming consultation reports/notes. Scan medical record information received via paper to the patient EHR- per any established protocol.

a. In compliance with all applicable policies and procedures, copies and sends all medical records as requested or ensures that requests for medical record information is forwarded to the medical records department. A signed, HIPAA-compliant patient release will be obtained prior to releasing any records.

b. Reviews outstanding diagnostic and referral orders.

6. Works to improve Press-Ganey patient satisfactions score

. Understands and employs the behaviors and principles consistent with the Language of Caring program to support an unparalleled patient experience.

a. Works effectively and cooperatively with other members of the team to identify opportunities for improvement in Press-Ganey results and actively participates in recommending plans of action to address any identified issues.

7. Other general duties as assigned/directed

. Maintains work area in a professional and organized manner.

a. Receives, sorts and distributes all incoming correspondence and mail on a daily basis.

b. Reconciles and accurately maintains the petty cash drawer and/or change drawer.

c. Maintains waiting room throughout the day.

d. Relays supply related information to others on a timely basis or orders supplies in accordance with established procedures. Contacts maintenance, housekeeping, and other departments for repairs or services as required or as directed.

e. Performs all other duties as assigned/directed.

f. Proficient in all aspects of PRS functionality.

Qualifications

Experience Minimum Required

• High school and or Office Practice courses.

• Customer Service Experience.

• 2-4 years' experience in healthcare or customer service field.

Education Preferred/Desired

• Higher education/training in any one of the following categories preferred: Associates Degree in Secretarial Sciences/Business and/or Secretarial training.

Training Preferred/Desired

• 2-4 years of related experience and/or training in similar medical practice/field.

Special Skills Minimum Required

• Mastery of Level 1 PSR and received at least an "Exceeds" performance evaluation.

• Successfully completed all modules of Language of Caring within 1 year.

• Successfully having a passing grade on the competency test.

• No Active Level 1 or higher progressive discipline on file.

EEO Statement

Wentworth-Douglass Hospital is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.