Patient Care Representative

Title Code:  44430

Occ. Group: 

Patient Care Representative

Expectations for All Employees

East Tennessee State University pursues its mission based upon core values. An employee's job performance must support and exhibit the university's core values:

PEOPLE come first, are treated with dignity and respect, and are encouraged to achieve their full potential;
RELATIONSHIPS are built on honesty, integrity and trust;
DIVERSITY of people and thought is respected;
EXCELLENCE is achieved through teamwork, leadership, creativity, and a strong work ethic;
EFFICIENCY is achieved through wise use of human and financial resources; and COMMITMENT to intellectual achievement is embraced.

Definition      

Employees in this class are under general supervision of the clinic’s front office manager.  Employees perform medical front office duties under general supervision.  Employees are the first point of contact for patients, outside providers, agencies and other entities.

Characteristic Duties and Responsibilities

Handles multi-line telephone system while simultaneously prioritizing calls according to urgency; selects the best appointment type or option based on each patient’s chief complaint while maintaining a professional telephone demeanor. 

Provides translation services (sign language, Spanish-English, etc.) or assists patients/family members in obtaining translation services. 

Maintains, updates, and otherwise ensures that information in the electronic health record (EHR) is current and accurate; this includes assimilating information (reports, correspondences, etc.) in various formats into the EHR. 

Maintains responsibility for following HIPAA compliance protocols and procedures for the release and transmission of EHR information to approved individuals and entities. 

Provides or assists in providing referral services, pre-authorizations, and outside appointment scheduling for patients; these duties may require advanced knowledge of coding and insurance requirements. 

Reconciles reports from hospital database with faculty reports of hospital rounds; creates new patient accounts in practice management system as needed, uses encounter codes and diagnosis codes to make decisions about what kind of charges are entered into the system, verifies insurance, and cashiers for billing purposes. 

Takes payments and performs data entry of over-the-counter charges at checkout; schedules follow-up appointments; balances cash drawer; maintains petty cash; reconciles patient encounter forms with daily batches; and, prepares or otherwise assists with bank deposits. 

Handles patient registration and certification of patient demographics; verifies insurance and payment status at time of appointment. 

Prepares requisitions for office supplies, receipts orders, and processes invoices for payment; organizes and replenishes office supplies; maintains Procards and records; processes travel arrangements; provides support; assists with daily deposits; and, creates clinical patient forms. 

Runs reports related to clinical operations, missed appointments, etc., as required, and takes various actions, including contacting patients, totaling, communicating information to others, etc. 

Manages own task list within EHR; takes action according to specific needs (scans, prints, obtains provider information and signatures, calls patients, directs medical information as required, provides information, contacts laboratory personnel, provides instructions, etc.), and documents actions within EHR. 

Retrieves messages received via telephone, fax, mail, or electronically, and directs to appropriate provider or station; scans or otherwise inputs information into EHR or practice management software as appropriate. 

Works closely with medical and clinical staff to ensure efficient patient flow and smooth clinic operations. 

Maintains responsibility for friendly interaction with a diverse array of patients and family members. 

Explains policies, procedures, and special services to internal and external customers. 

Performs or assists in performing special projects for Center Manager, Medical Director, administrators, and faculty as needed.  

Serves on committees as needed.

Provides back-up for absent front office employees including: telephone, charge entry, front window patient registration, checkout, medical records, messages, mail distribution, scanning, etc. 

Performs other related duties as assigned.

Required Knowledge and Abilities

Knowledge of Patient Centered Medical Home standards and guidelines for quality patient care.

Knowledge of electronic health records and electronic practice management.

Knowledge of Medicare, Medicaid and commercial insurances.

Ability to use electronic records and practice management systems.

Ability to maintain compliance with the Health Insurance Portability and Accountability Act.

Ability to process office supply orders and travel authorizations/reimbursements according to policies and procedures.

Ability to be flexible in adjusting and implementing changes in protocol, procedure, and work flow.

Ability to use business English in written and verbal communications.

Ability to perform data entry accurately.

Ability to function as a team player in a patient-centered health care setting.

Ability to learn and effectively utilize electronic health records and practice management software.

Ability to work in a fast paced environment with frequent interruptions.

Ability to use proper telephone etiquette.

Ability to follow proper policies, procedures, and instructions in accomplishing tasks.

Ability to work with a diverse population, along with the ability to treat all patients and co-workers with dignity and respect. 

Recommended Qualifications

Applicants possessing these qualifications have a good probability for success in this class. However, applicants not possessing these qualifications should apply if they believe their training and experience will enable them to perform the work successfully. Graduation from a standard high school or equivalency required with two years of medical office experience; or, at least one year post-high school course level work with one year of medical office experience.

  Date       Skill         Eval            
8/2014       6         513032322

The intent of this job description is to provide a representative summary of the types of duties and responsibilities that will be required of positions given this title and shall not be construed as a declaration of the specific duties and responsibilities of any particular position.