Patient Representative

# Positions
Job Status
Regular Full-Time
10004 N. Dale Mabry Hwy

Job Description

Patient Representative

Department:               Family Medicine Dale Mabry

Job Summary:           Manages referrals and performs front office functions

Reports to:                 Supervisor

Position Level:          4



Essential Functions of the Position:

  • Assist traffic at front window
    • Manages sign in sheets
    • Schedules appointments
    • Takes messages
    • Assists with medication refill requests
    • Handles customer requests or needs
    • Assists vendors
    • Monitors the lobby for cleanliness and patients in distress
  • Completes patient check in processes
    • Distributes and collects new patient forms
    • Verifies HIPAA and Privacy signatures are obtained
    • Confirms photo ID is scanned into Intergy
    • Confirms insurance cards are scanned into Intergy and keyed correctly
    • Obtains patient signature on DVF at each visit
    • Updates patient demographics as needed, including insurance and preferred pharmacy
    • Updates work flow event to “check in”
    • Records “no show” appointments in the system
  • Assists patients and providers at the conclusion of the patient’s visit
    • Obtains patient signature for record releases and other forms as necessary
    • Reviews Intergy tasks for each patient before they leave
    • Schedules inside and outside appointments for testing and consults
    • Enters referral information into the Practice Management System for referral tracking
    • Schedules follow up appointments
    • Enters recalls as needed
    • Requests referral if needed for upcoming visits and/or testing
    • Obtains ABN forms when appropriate
    • Updates work flow event to “check out”
    • Reviews and posts all pending charges for the department
    • Pulls charges from pending status and reviews for accuracy
    • Creates ailments if an appropriate ailments doesn’t already exist
    • Ensures modifiers are in place as appropriate
    • Ensures the referral is attached to the visit via ailment or appointment
    • Attaches the appropriate insurances to each charge
    • Reviews unresolved encounters for the day
    • Collects and processes monies due
    • Collects outstanding patient balance dues
    • Balances journal and locks it
    • Creates a journal for next day
    • Secures deposit and imprest funds
    • Addresses Intergy tasks in a timely manner
  • Answers phones and assists callers
    • Answers phones and assists callers
    • Obtains pertinent information for messages and routes messages per office protocol
    • Places phones on and off service at the appropriate times
    • Places a test call to ensure service is working after placing on service
    • Retrieves messages from answering service or mail box
    • Distributes messages from answering service or mail box to the appropriate person
  • Scans all medical record documentation into IEHR utilizing company approved cataloguing system
    • Scans incoming medical records, daily work, and paper charts into IEHR
    • Creates an imaging task as needed
    • Reports scanning errors following company approved process
  • Processes medical record releases as outlined in the authorization
    • Submits request for pre-payment of records or forms
    • Reviews record releases to ensure appropriate authorizations have been obtained
    • Prints required information and copies paper records
    • Reviews subpoenas, determine if an appearance is required
    • Creates charges for records and post to journal
    • Documents disclosure in Practice Management System
  • Facilitates office communication
    • Attends meetings as required
    • Notifies and educates employees and providers of new policies and procedures
    • Provides flow of information between providers, management, and staff related to referrals and insurance
    • Directs incoming faxes to correct staff members
    • Notifies providers and staff of changes in the referral process or insurance requirements
  • Handles tasks and assignments
    • Investigates and resolves CBO tasks in a timely manner to maintain optimal efficiency and billing in the department
    • Addresses  software, hardware, phone issues and creates IT tickets if unable to resolve, and monitors ticket statuses daily when requested by the Supervisor or Physician
    • Oversees office inventory and generates purchase requisitions
    • Coordinates outside chart audits with Cioux
    • Schedules legal conferences and or depositions
    • Prepares referrals and obtains authorizations for Managed Care patients
    • Enters referral authorization information into Practice Management System
    • Obtains approval from the PCP for requested authorizations
    • Schedules appointments, and procedures
    • Notifies patients of the appointments
    • Forwards  clinical data to the scheduled facility
    • Notifies provider and patient of denied requests for authorization
    • Coordinates admissions with providers and facilities
    • Coordinates equipment
    • Maintains updated network information
  • Maintains MRA date and updates E-Star as required by Managed Care Carriers


Additional Responsibilities:

  • Maintains an organized and clean work area
  • Directs incoming faxes and mail to correct staff members
  • Monitors and timely responds to practice portal requests
  • Participates in maintenance of office supplies
  • Performs other incidental and related duties as required and assigned
  • Organizes and maintains sample and supply closets


Physical and Mental Demands:

  • Normal physical ability
  • Normal concentration and normal complexity of decision making
  • High level verbal and written communication skills
  • Above average ability to manage multiple tasks simultaneously


Occupational Exposure:

  • High risk exposure to bloodborne pathogens and chemical hazards


Job Qualifications:

  • High school graduate or GED equivalent
  • Completion of MA certification program
  • Strong customer service orientation
  • Excellent telephone etiquette
  • Basic computer proficiency
  • Strong team player



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