Primary Care Customer Experience Representative Details

Primary Care Customer Experience Representative

Banner Health - Mesa, AZ

Employment Type : Full-Time

Primary City/State:

Mesa, Arizona

Department Name:

BMG AZ West Float Pool

Work Shift:

Day

Job Category:

Clinical Support

At Banner Medical Group, you'll have the opportunity to perform a critical role in the community where you practice. Banner Medical Group provides both primary and specialty care throughout the communities in which Banner Health operates. We do this in a variety of settings - from smaller group practices like our Banner Health Clinics in Loveland, Colo. and Torrington, Wyo., to large multi-specialty Banner Health Centers in the metropolitan Phoenix area. We currently have more than 1,000 physicians and more than 3,500 total employees in our group and are seeking others to enhance our ability to deliver our nonprofit mission of providing excellent patient care.

POSITION SUMMARY
This position is located in a medical clinic or physician’s practice and coordinates a smooth patient flow process by answering phones, providing registration of patient and insurance information, obtaining required signatures following established processes, procedures and standards. This position conducts registration and obtains financial reimbursement for all patients accessing service at clinics and physician practices. Reviews all account information to optimize collection efforts and system recording events to expedite reimbursement and compliance. This also includes accurately posting patients at the point of service and releasing information in accordance with organizational and compliance policies and guidelines. And resolving issues as they arise to promote point of service decisions.

CORE FUNCTIONS
1. Performs registration/check-in processes, including but not limited to performing data entry activities, providing patients with appropriate information and intake forms, obtaining necessary signatures and generating population health summary. Assists front office in answering phones, taking messages, prescription refills, locating information and other related duties when necessary. Documents correspondence in the patient’s medical record. Updates demographic and insurance information in the practice management system.

2. Receives physician’s orders and completes patient registration. Obtains necessary authorizations, pre-certifications and/or referrals. Works closely with the billing department to ensure accurate coding for all charges. Verifies insurance eligibility benefits for services rendered with the payors and documents appropriately. Assists in obtaining or validating pre-certification, referrals, and authorizations.

3. Calculates and collects patient liability according to verification of insurance benefits and expected reimbursement. Explains and provides financial policies and available resources for alternative payment arrangements to patients and their families.

4. Enters payments/charges for services rendered and performs daily payment/charge reconciliation in a timely and accurate manner. Balances cash drawer at the beginning and end of the day and prepares daily bank deposit with necessary paperwork sent to centralized billing for record purposes.

5. Confirms patient appointments for the following day as necessary and ensures patients are properly prepared for visits. Assists in responding to requests for patient medical records according to company policies and procedures, and state and federal laws.

6. Provides information and customer service to patients and patient families. Provides information and instructions to patients regarding clinic procedures and services.

7. Performs general office duties such as distributing mail and fax information, ordering supplies, etc.

8. Works under direct supervision and follows structured work routines. Works in a fast paced, multi task environment with high volume and immediacy needs requiring independent decision making and sound judgment to prioritize work and ensure appropriateness and timeliness of each patient’s care. This position requires the ability to retain large amounts of changing payor information/knowledge crucial to attaining reimbursement for the services provided. Primary external customers include patients and their families, physician office staff and third party payors.

Performs all functions according to established policies, procedures, regulatory and accreditation requirements, as well as applicable professional standards. Provides all customers of Banner Health with an excellent service experience by consistently demonstrating our core and leader behaviors each and every day.

NOTE: The core functions are intended to describe the general content of and requirements of this position and are not intended to be an exhaustive statement of duties. Specific tasks or responsibilities will be documented as outlined by the incumbent's immediate manager.

SUPERVISORY RESPONSIBILITIES
DIRECTLY REPORTING
None
MATRIX OR INDIRECT REPORTING
None
TYPE OF SUPERVISORY RESPONSIBILITIES
N/A

Banner Health Leadership will strive to uphold the mission, values, and purpose of the organization. They will serve as role models for staff and act in a people-centered, service excellence-focused, and results-oriented manner.

PHYSICAL DEMANDS/ENVIRONMENT FACTORS
OE - Typical Office Environment: (Accountant, Administrative Assistant, Consultant, Program Manager)
Requires extensive sitting with periodic standing and walking.
May be required to lift up to 20 pounds.
Requires significant use of personal computer, phone and general office equipment.
Needs adequate visual acuity, ability to grasp and handle objects.
Needs ability to communicate effectively through reading, writing, and speaking in person or on telephone.
May require off-site travel.

MINIMUM QUALIFICATIONS

High school diploma/GED or equivalent working knowledge.

Requires knowledge of patient financial services, financial, collecting services or insurance industry experience and customer service skills as normally acquired over one or more years of related work experience. Requires the ability to build familiarity with medical terminology and an understanding of all common insurance and payor types. Accurate and efficient keyboarding skills, and the ability to work effectively with common office software are required. Must have highly developed interpersonal skills and communications skills, with a strong customer service orientation to effectively interact with a wide range of audiences. Requires the ability to manage multiple tasks simultaneously with minimal supervision and to work independently. Requires strong interpersonal, oral, and written communication skills.

PREFERRED QUALIFICATIONS

Previous medical, financial services and/or customer service work experience preferred.

Additional related education and/or experience preferred.

DATE APPROVED 08/27/2017