Download JD11-RheumatologyIVDepartmentServicesRep2-10

Job Description
Rheumatology IV Department Services Representative
SUMMARY OF POSITION:
Responsible for insurance verification, ensuring required preauthorization for infusions have been received, and reviewing patient balances.
DEPARTMENT:
Rheumatology
REPORTING RELATIONSHIP:
Reports to Practice Manager
DRESS CODE:
Clerical
MAJOR RESPONSIBILITIES:
 Identify yourself to internal and external customers by wearing your identification badge at all times.
 Greet patients with courtesy and respect. Answer questions and direct requests appropriately and
efficiently.
 Schedule patient appointments within the prescribed protocol.
 Prepare charge tickets for the next day appointments.
 Promptly and accurately answer patient questions.
 Answer telephones promptly and in a professional manner. Take a comprehensive message when
appropriate. If transferring the call, advise the patient prior to the transfer. Follow-up as appropriate
to resolve the caller’s issues.
 Operate computer within the guidelines of _________________.
 Obtain all insurance information prior to patient appointment.
 Verify and update patient demographic, financial class, and insurance information for each patient
encounter.
 Accurately load patient information.
 Verify initial patient benefits by utilizing appropriate drug verification resources.
 Verify patient new insurance benefits by utilizing appropriate drug verification resources.
 Verify patient benefits annually by utilizing appropriate drug verification resources.
 Obtain prior authorizations for treatment when required by insurance company.
 Notify physicians regarding any “Letters of Medical Necessity” required by insurance companies,
obtain, and submit.
 Review patient account one (1) week prior to appointment to ensure insurance(s) have paid
appropriately and to identify patient balances.
 Verify patient appointment via telephone prior to patient appointment.
 Review account balances with patient via telephone prior to appointment to make payment
arrangements.
 Notify physician and practice manager of any accounts with no payment activity by insurance
companies or patient.
 Act as a liaison between patients and drug companies offering financial assistance.
 Identify problems, issues or concerns. Seek areas for improvement.
 Maintain a ‘check and balance’ system by comparing charges to daily infusion schedules.
 Re-schedule patients as necessary, including removal of cancelled appointment.
 Attend quarterly professional training sessions (i.e., skill specific).
 Perform tasks and duties of absent staff members, as needed.
 Attend events and other _________________ functions as appropriate.
 Empower all personnel to deliver top-notch customer service.
 Promote teamwork!
 Other duties, special projects or reassignments as directed by Practice Manager.
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MAJOR CORPORATE CULTURE RESPONSIBILITIES:
 Follow established corporate and departmental policies and procedures.
 Attend all corporate and departmental required training.
 Comply with _________________ Service Standards:
Make first impressions positive ones. Greet all patients, visitors and co-workers in a pleasing manner
with eye contact, a verbal greeting, and a smile.
Maintain a professional appearance. Wear your name badge at all times. Comply with the uniform policy
for your job description. Confine gum chewing and eating to break areas; save personal conversations
for break times; turn off non-work related cell phones. Maintain a neat and clean work and Clinic area.
Demonstrate positive attitude. Interact with all patients, visitors and co-workers in a professional and
upbeat manner. Be courteous, respectful, friendly, and helpful. Express yourself and your concerns
using helpful words versus confrontational words or profanity. If you are unable to maintain a positive
approach, remove yourself from the situation.
Demonstrate a team attitude.
Remember you are part of a team, and the success of
_________________ is everyone’s responsibility. If you don’t know how to assist a patient or co-worker
with an issue, find someone who can. Be personally responsible for making sure issues are addressed.
Make lasting impressions positive ones. Maintain patient privacy and confidentiality at all times. End
your interactions with patients, visitors and co-workers with a friendly or kind word. Make sure patients
waiting alone at the front door have transportation home.
 Perform other duties as may be assigned cheerfully and willingly.
QUALIFICATIONS:
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Demonstrated customer-service skills.
Be a person of integrity and character, willing to embrace change and make a positive impact in the
lives of patients and co-workers.
Ability to work with staff members at all levels of the organization in a cooperative, team-oriented
manner.
Minimum education requirement is a high school diploma or GED.
Two years experience in a healthcare environment, preferably in a physician practice.
Proficient in PC windows environment.
Proficient in use of English language both in written and verbal communication. Must be able to
communicate with individuals of varying socio-economic backgrounds.
Ability to work in various positions (standing, sitting, bending, walking) for extended periods of time
during an 8-hour workday.
Ability to remain calm and professional regardless of workload or time constraints.
KNOWLEDGE:
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Customer and Personal Service - Knowledge of principles and processes for providing quality
medical services. This includes customer, physician and staff needs assessment, meeting quality
standards for services, and evaluation of customer satisfaction.
Administration and Management - Knowledge of business and management principles involved in
strategic planning, resource allocation, human resources modeling, leadership technique, production
methods, and coordination of people and resources.
Personnel and Human Resources - Knowledge of principles and procedures for personnel
recruitment, selection, training, labor relations and negotiation, and personnel information systems.
Ability to work collaboratively with Human Resources staff.
Management Principals and Practices – Knowledge of principles and procedures of effective
management practices.
Medical Terminology - Knowledge of medical terminology.
Medical Coding – Knowledge of Current Procedural Terminology (CPT) and ICD-9 diagnostic coding.
Clinical Knowledge - Knowledge of relevant equipment, policies, procedures, and strategies to
promote effective medical operations safely for the protection of people, data, property, and
institutions, on a department specific level.
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Establishing and Maintaining Interpersonal Relationships - Developing constructive and cooperative
working relationships with others, and maintaining them over time.
Making Decisions and Solving Problems - Analyzing information and evaluating results to choose the
best solution and solve problems.
Monitor Processes, Materials, or Surroundings - Monitoring and reviewing information from materials,
events, or the environment, to detect or assess problems.
Coordinating the Work and Activities of Others - Getting members of a group to work together in order
to accomplish tasks.
Communicating with Supervisors, Peers, or Subordinates - Providing information to supervisors, coworkers, and subordinates by telephone, in written form, e-mail, or in person.
Maintain presence In Departments.
Departmental Organization – Identify, organize and fully understand the allocations, percentages of
compensation and other department-specific strategies.
SKILLS:
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Active Listening - Giving full attention to what other people are saying, seeking first to understand,
then to be understood, asking questions as appropriate, and not interrupting at inappropriate times.
Reading Comprehension - Understanding written sentences and paragraphs in work related
documents.
Critical Thinking - Using logic and reasoning to identify the strengths and weaknesses of alternative
solutions, conclusions or approaches to problems.
Speaking - Talking to others to convey information effectively in a professional and courteous
manner.
Monitoring - Monitoring/Assessing performance of yourself, other individuals, or organizations to
make improvements or take corrective action.
ABILITIES:
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Oral Comprehension - The ability to listen to and understand information and ideas presented through
spoken words and sentences.
Deductive Reasoning - The ability to apply general rules to specific problems to produce reasonable
solutions.
Inductive Reasoning - The ability to combine pieces of information to form general rules or
conclusions (includes finding a relationship among seemingly unrelated events).
Oral Expression - The ability to communicate information and ideas in speaking so others will
understand.
Problem Sensitivity - The ability to recognize when there is a problem.
Written Comprehension - The ability to read and understand information and ideas presented in
writing.
Prioritize – The ability to deal with or arrange tasks in order of importance or urgency.
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