Patient Service Representative

🦷If you are passionate about making a difference in patients' lives and are dedicated to providing exceptional dental care, we invite you to join our team!🦷

Benefits & Perks:

• Paid Holidays
• Additional Paid Time Off (PTO)
• Qualifying Non-For-Profit for Federal Student Loan Forgiveness Program (click here to learn more: https://studentaid.gov/manage-loans/forgiveness-cancellation)
• Casual dress code
• Health, dental & vision insurance options
• Free dental insurance
• Paid Employer sponsored life insurance.
• Supplemental insurance programs for additional life insurance, short-term disability, accident & cancer insurance
• Up to $600 every year for completing biometric health screenings on a single health insurance plan & up to $1,200 if a spouse also completes
• Up to $180 annual gym reimbursement
• Take advantage of our Dental & Outpatient Mental Health services while working
• Employee referral program

Salary range: $15.59 - $22.50 per hour.

Job Summary: 
The Baker Victory HealthCare Center provides high quality and affordable dental care to our patients.  We serve a variety of patients from the community, including individuals with intellectual and developmental disabilities or other special needs. The Patient Service Representative will perform front desk responsibilities related to the check-in, check-out, insurance verification, scheduling of patients, and preparing the office for next day’s patients. This position is fast paced and high volume, serving up to 100 patients per day.

Essential Job Duties:
- Answering phones, scheduling and confirming appointments, collect appropriate demographic and insurance information from patient or representative.
- Performs administrative duties such as copying correspondence, insurance cards, preparing mailings and the collection and distribution of mail and messages.
- Ensures accurate data entry.
- Managing patient insurance verifications utilizing other 3rd party payer portals verification systems.
- Demonstrates friendly, courteous attitude in all communications.
- Operating computer using dental practice management software, internet and other vendor related programs.
- Maintain a neat and orderly work environment.
- Check patients in and out.
- Runs daily reports consistent with the needs of the dental center
- Any other duty as assigned by your Supervisor.
- Employee is expected to perform specific roles and duties as outlined below:

Specific Roles within the PSR Job Function:

Insurance Verifications:
• Verifies and analyzes insurance plans, benefits, and coverage and updates insurance master in Eaglesoft.  Communicates appropriate and relevant information to healthcare center team.  
• Reviews patient accounts and evaluates balances owed; negotiates payment terms collecting outstanding balances prior to next scheduled visit/treatment
• Requests, verifies, and scans prior authorizations/referrals
• Stays abreast of plan coverage changes educating team members
• Coordinates scheduling efforts with department dental professionals
 
Predeterminations:
• Prepares and submits pre-determination inquires to 3rd party payers including radiology films and additional clinical documentation
• Provides follow up notification to patient on approval or denial of coverage; schedules approved procedures
• Prepares patient pre-determination financial responsibility letter according to coverage and plan cost share guidelines; informs patient of financial responsibility 
• Reviews terms of services with patient, guardian and notifies dental team of the approval or denial of the predetermination
 
Billing Review:
• Post payments and denials
• Utilizes denial reports to assess root causes of dental claim denials monitor denials for frequency, eligibility, clinical; takes necessary action to correct denial and allow for resubmission.  and shares findings with all department stakeholders
• Monitors specific frequency denials and keeps dental leadership informed
• Serves as a Liaison between patient, dental professional, and financial team
 
Documentation Review:
• Maintains accurate and timely review of clinical documentation against posted charges; engages provider to mitigate documentation and coding errors
• Reconciles daily schedules and charges
• Creates electronic claim for submission to 3rd party payors
• Provides ongoing education on support to the Dental Professionals on changes
• Generates daily reports documenting the history of the daily department clinical documentation activities
 
Booking Appointments:
• Responsible for answering phone calls and scheduling patient appointments.
• Conduct patient pre-certification to ensure coverage for appointments and medical care.
• Schedule tests, procedures, and referral appointments.
• Communicate with patients regarding appointments and instructions for procedures and tests.
 
Skills:
• Computer/database Experience (Eaglesoft)
• Customer Service skills
• Multi-tasking skills
• Knowledge of dental procedures
 
Competency Template: Administrative
 
Minimum Education Required:
High School Diploma
(Associate’s Degree preferred)
 
Minimum Experience Required:  
1-2 years of administrative experience, dental office experience preferred
 
License/Registration/ Certifications Required:
- None
 
Training Requirements:
- New Hire Orientation
 
Physical Requirements:
• The overall nature of the position is sedentary requiring little physical effort with occasional light physical exertion required. There is little, if any, exposure to environmental conditions.
•The constant physical demands of the position are sitting, talking, hearing.
• The frequent physical demands of the position are standing, walking, climbing, repetitive motions, and eye/hand/foot coordination.
• The occasional physical demands of the position are lifting, carrying, pushing, pulling, balancing, stooping, crouching, reaching, handling, grasping, and feeling.