Client Support Representative (Outpatient Behavioral Health Clinics)

Summary: Under general supervision, the Client Support Representative serves as first point of contact to patients, their families/representatives, outside agencies, and referrers to respond to inquiries for outpatient admission or referral. Gathers demographic and insurance data, identifies appropriate clinicians, and schedules appointments. Works closely with other offices to coordinate efforts and ensure timely, quality customer service for all inquiries. Demonstrates knowledge of Sheppard Pratt programs and services in interactions with internal and external groups. Enters required information and charges into on-line system.Verifies insurance coverage and benefits and acquires proper pre-authorization. Provides clerical assistance to front office.

Principal Responsibilities and Duties:

Orientation to Customer Relations/Marketing:

• Actively seeks to provide quality services that meet the needs of patients as well as other customers-families, referrers, payers, clinicians and staff.
• Provides patients and referrers responsive intake/telephone service that reflects knowledge of internal programs and services as well as community providers, programs, support groups and other resources.
• Develops and maintains good working relationships with managed care companies and other referrers. Solicits and shares referrer feedback with Director and staff.

Data Collection/Documentation:

• Gathers required demographic and insurance data, ensures that patient has completed all information to provide past psychiatric history. Demonstrates understanding of the needs of client population (age and diagnosis) in interaction with clients.
• Enters data and initiates patient registration and other required recordkeeping in computer system(s) to facilitate billing, tracking of patient and referral source, and other data reporting.
• Presents, explains, and obtains signatures on various required forms and documents. Explains the policy, patients' rights and responsibilities included in the client handbook.
• Collects co-pays and issues a receipt.

Insurance Verification:

• Identifies, prioritizes, and coordinates insurance requirements, needs for pre-certifications, and other gatekeeper requirements and communicates critical data to clinician and Financial Office representatives.

Medical Records and Charting:

• Opens and assembles charts. Enters demographic and diagnostic information into the computer system.
• Requests appropriate after care, discharge, and foster care information.
• Requests medical information from the primary care physician.
• Filing: charts, loose paperwork, and pulling prepared charts for clinical appointments.

Office Secretarial/Clerical Support:

• Provides clerical support to clinical staff. Serves as telephone receptionist. Uses on-line scheduling system to schedule patient appointments. Collects time of service payments. Files, photocopies, and performs other support functions as needed.

Requires:

• Work requires the ability to read, write, speak English, compose letters, maintain bookkeeping records, and operate computer software and equipment - normally acquired through a generalized high school education.
• Work requires knowledge of community resources in social, medical, and mental health areas, and knowledge of health insurance terminology, plan coverage, carriers, and reimbursement procedures - normally acquired through at least 1 year of outpatient office support or related experience.
• Must be proficient in the use of personal computer with Windows and WordPerfect software, calculator, dictaphone and other automated office equipment.
• Work requires interpersonal skills to communicate effectively with patients, all levels of internal staff, external contacts from the professional community, and outside agencies, and demonstrate understanding of the needs of patient age and diagnosis group(s).
• Work requires analytical ability sufficient to gather and interpret data, apply knowledge of Health System programs to patient needs, investigate and resolve patient concerns and questions, maintain outpatient admission and insurance records, and handle designated administrative detail.
• Work requires placing telephone calls and requests for medical records, verifying insurance coverage, filing, data entry, setting up records, paying close attention to detail and meeting deadlines and very frequently produces a high level of mental/visual fatigue.
• General sedentary work, but requires standing and walking in order to photocopy, file, and run errands within and between office locations.