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Patient Services Representative

Company: PRISM Vision Group
Location: Silver Spring
Posted on: March 16, 2023

Job Description:


The Patient Services Representative is responsible for scheduling and registering patients for appointments. Success in this position requires the ability to utilize the scheduling system to search for appointments across multiple physicians, resources, while utilizing understanding of insurance requirements to ensure patients are scheduled with the appropriate provider within a convenient time frame.


  • Schedule and accurately complete full registration for patients requesting appointments adhering to policies and procedures regarding appointment scheduling and registration processes, performing these tasks accurately with attention to detail to ensure the highest quality standards.
  • Initiate pre-registration process and ensure all demographic insurance information is accurate, complete and up to date on patient's screen.
  • Verification of insurance information, verification of benefits and insurance referral information.
  • Verification of private patient insurance information for same day appointments or by request.
  • Adhere to HIPPA standards related to patient privacy and confidentiality.
  • Obtain legal photo identification and (if applicable) insurance card (s), and validate patient identity and coverage (if applicable) prior to services being rendered thereby ensuring patient safety and financial reimbursement.
  • Assure ease of patient flow through clinical care process.
  • Provide patients with all required information regarding appointments and payment policies (e.g. medical records, parking, cash policies, anticipated charges, cancellation policy).
  • Intervene as liaison/advocate for patients, physicians, and staff in facilitating ease of care.Assist in identifying trouble spots and problem patterns in the provision of care.
  • Maintain a working knowledge of medical symptoms, signs, and anatomical systems to identify and differentiate type and urgency of medical need.
  • Maintain knowledge of insurance referral requirements to ensure access based on third party reimbursement criteria.
  • Notify appropriate parties of the appointment time, referral criteria, insurance verification, and prior authorization requirements.
  • Performs all above-mentioned tasks by paying attention to detail and providing excellent customer service skills with Patients, Physicians and other related members
  • Maintains positive attitude consisting of cooperation, self-motivation, courtesy, and professionalism.
  • Comply with company compliance policies and standards POSITION QUALIFICATIONS

    Education & Experience: High School Graduate or General Education Degree (GED) with 3 years prior experience in patient facing healthcare function or hospitality customer service function. Associate's Degree w/1-2 years' experience or Bachelor's degree w/1 year experience is preferred.

    • Working knowledge of medical symptoms, signs, and anatomical systems to identify and differentiate type and urgency of medical need.
    • Knowledge of insurance referral requirements to ensure access based on third party reimbursement criteria.
    • Excellent verbal and written communications skills in English. Bi-Lingual (English/Spanish, English/Polish, English/French, English/Arabic) a plus.
    • Must possess excellent, critical thinking, analytical, troubleshooting, problem resolution, and customer service skills.
    • Excellent mathematical and cash management skills.
    • Excellent interpersonal skills and ability to work effectively with physicians, co-workers, other departments and patients of all ages, and from across a broad range of cultural and social economic backgrounds.
    • Ability to work as an integral team member under minimal supervision, in a fast-paced, complex environment.
    • Ability to show tolerance and sensitivity in stressful situations and safeguard confidential information in accordance with established policies and HIPAA regulations.
    • Computer literate and ability to use multiple systems and acquire proficiency in multiple electronic systems Computer Skills
      • Facile with Microsoft Products
      • Within 4 weeks of hire must be facile with Athena PMS, MDI EMR, QuickBase, Availity, Eyefinity, Pear Portal, NextPatient, MoJo, Navinet

        WORK ENVIRONMENTAn office environment with controlled atmosphere. Possible exposure to staff or patients with communicable diseases and blood borne pathogens.

Keywords: PRISM Vision Group, Silver Spring , Patient Services Representative, Other , Silver Spring, Maryland

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