Boston Medical Center
The Patient Service Representative (PSR) will be the first point-of-contact for BMC patients. They are responsible for answering inbound calls, emails and on-line appointments, for various BMC's Practices, including, Primary Care, Medical Specialties, Family Medicine and other Practices within BMC. The PSR will handle all patient inquiries, including, but not limited to scheduling and/or rescheduling appointments, conducting follow up calls with patients, resolving patient questions/concerns regarding medication refills, insurance verifications and other activities to satisfactorily resolve patient requests. They will document patient information in the appropriate hospital systems as required by the Practice Guidelines.The Patient Services Rep will be responsible for handling inbound and outbound communications for BMCs Primary Care Practice. The Patient Services Rep will handle patient inquiries, scheduling/rescheduling appointments, following-up with patients resolving patient questions/concerns regarding medication reconciliation and refills, and insurance verification and authorization management. They will document and relay patient information to the Practices as required by the Practices Guidelines.
ESSENTIAL RESPONSIBILITIES / DUTIES:
The Patient Services Rep is intended to extend the capabilities of the Practice by working as a partner to the Practice Team and supporting the major work flows in the Practice. Duties include:
The Patient Services Rep communicates with patients and staff using multiple advanced communication tools, including phone calls, online chats, emails, faxes or mail.
Answers and resolves patient inquires, in a professional, empathetic and patient-centered way, through the use of effective listening, written and verbal communication skills.
Utilizes established Practice guidelines to ensure patients issues are addressed in a timely manner and when necessary, transfers the call to the appropriate person at the Practice for additional consultation.
Uses a computerized scheduling system to schedule/reschedules appointments determining the right amount of time required for each patient appointment.
Provides accurate and detailed information and updates patients records, using the various management information systems used at BMC: Logician, EWS, SDK and others.
Sends detailed confirmation to the patient detailing where and when the appointment is, providing directions as needed, providing applicable and language specific home instructions as well as instructions for any required labs or imaging.
The conclusion of the pre-visit prep process is the production of a traveler document that will accompany the patient during their visit with the physician. The traveler will summarize the information collected during the pre-visit process, along with all information from the patient record, to help guide the physician in their care planning activities.
Follows up with the Patient after a visit to confirm understanding and compliance with the care plan developed by the Physician (care plan management). Assists patient with completing authorizations, managing and coordinating referrals and assisting with prescription refills.
Processes referral and works with insurance companies to initiate and follow-through on all required prior authorizations for care.
Identifies opportunities to improve the work processes and environment, and changes in Practice protocols; remains current on new developments in health care.
Escalates appropriately any issues that fall outside of an existing protocol or process to meet the needs of the patient
Attends scheduled training sessions for phone support, customer service, systems upgrades, newly acquired clinical systems, or other relevant training sessions, as directed by manager.
Assists in the training/orientation of new personnel under the direction of a manager and/or supervisor.
Participates in staff meetings/is expected to identify process issues that are obstacles to providing a positive patient experience.
General Duties and Standards
Adapts to changes in the departmental needs including but not limited to: offering assistance to other team members, floating, adjusting assignments, etc
Conforms to hospital standards of performance and conduct, including those pertaining to patient rights and HIPAA and privacy rules, so that the best possible customer service and patient care may be provided.
Utilizes hospitals behavioral standards as the basis for decision making and to support the department and the hospitals mission and goals.
Follows established hospital infection control and safety procedures.
Other duties as needed.
A minimum of a High School diploma/GED is required. Training as a Medical Assistant, Pharmacy Technician, or other relevant healthcare background, training and/or experience that will be provide the ability to understand and be fluent in medical terminology is also required.
Experience in the medical field or as a call center or customer service agent is preferred.
Experience should be equivalent to one of the following:
- Bachelors degree (related experience would be preferred but not required).
- Associate degree, Medical Assistant certificate or equivalent training plus at least 1 year related work experience or
- High School diploma/GED plus at least 2 years medical office or call center work experience required.
KNOWLEDGE AND SKILLS:
Familiarity with medical terminology and be able explain healthcare issues to patients with empathy and concern
Ability to empathize with and coach the patient in navigating the healthcare system
Effective interpersonal skills to with a diverse group of professional and personalities in a team environment
Excellent English communication skills (oral and written) with the ability to communicate effectively with patients over the phone and in email and other communications
Must be comfortable using multiple advanced communication tools, including phone calls, online chats, emails, faxes or mail.
Basic computer skills and knowledge of Microsoft Office applications (MS Word, Excel & Outlook) and document work in a professional and efficient manner
Have strong interpersonal skills and be able to work well in a team environment.