The Patient Access Representative Lead assists patients with the check-in/arrival. Has in depth knowledge in all processes of the reception front desk and arrival process. Works with physicians on coordinating new patients for their individual schedules, assist new patients in collecting all medical records and history. He/She will schedule new patients with physician who specializes in care type and prepares new patient chart for physician review. Responsible for providing insurance information to Financial Counselor Representative for verification. Has lead role responsibilities.

Provide front office support for ophthalmology multispecialty group practice including greeting patients, performing patient check-in/out processes, assuring patients are appropriately registered and insurance information is accurate. Uphold smooth patient flow throughout the front office experience to ensure efficiency and effectiveness. Demonstrate exemplary customer service. Act as a liaison between the front office and communications' center. In addition, provide administrative support including collecting patient payments, performing insurance verification, scheduling patient follow-up appointments and/or ancillary testing, obtaining records/authorizations, and creating encounter(s) in patient registration system(s). The Front Office Lead also serves as an exemplary resource to patients, faculty, and staff. Additional responsibilities include cross-training, productivity metrics oversight, and assistance with ongoing administrative activities. Daily interactions with staff, supervisor, and doctors, as well as periodic meetings with senior operations manager. Incumbent is expected to work with minimal supervision; periodic and regular progress checks are performed to evaluate and adjust workload accordingly.

Essential Duties:

• Greet Patients and Perform Check-In Process Interface with electronic medical records and scheduling system(s). Provide excellent customer service. Verify/update demographic and insurance information. Confirm/obtain Primary Care Provider and Referring Provider information. Scan insurance/ID card(s) and any other pertinent insurance material(s). Explain consent/HIPAA forms and noncovered services forms to patient and obtain patients signature(s) on all relevant forms. Assure patient has completed patient questionnaire(s), as needed. For managed care patients, assure that preauthorization is present, when needed, and that preauthorization is accurate. Accurately collect co-payments/deductibles and patients fees for services via check, cash, or credit card and document, per protocol. Arrive patients using the proper registration system(s). Politely inform patients of possible delays relating to their appointments. Collate chart appropriately in preparation for technician and provider to see the patient. Perform patient encounter in computer system(s). Perform all tasks in a safe manner in compliance with organizational safety policies and according to applicable regulations; maintain a neat workstation and environment. Maintain confidentiality of all records and information that pertains to patients, physicians, employees, the organization and in related interests.
• Greet Patients and Perform Check-Out Process Interface with electronic medical records and scheduling system(s). Provide excellent customer service. Collect payments from all self-paying patients and from insured patients receiving non-covered services or needing to pay co-payment(s)/deductible(s). Prepare patient receipts accordingly. Perform patient insurance verification for all patients. Schedule future appointments, procedures, ancillary testing and/or enter recalls as indicated by patients provider(s). Confirm/obtain Primary Care Provider and Referring Provider information. Provide disposable dark glasses (i.e. mydriatic specs) for patients that have been dilated. Make calls for patient transportation, upon appropriate patient request. Collate chart appropriately. Perform all tasks in a safe manner in compliance with organizational safety policies and according to applicable regulations; maintain a neat workstation and environment. Maintain confidentiality of all records and information that pertains to patients, physicians, employees, the organization and in related interests.
• Patient Registration and Appointment Scheduling Obtain, document and update in appropriate system(s) all necessary patient information. This involves interaction with various insurance companies, and other payors/institutions. Verify coverage with appropriate insurance or health care plan carrier. Accurately coordinate the registration, referral, and scheduling activities of the Roski Eye Institute. Ensure patients are accurately scheduled. Input validated patient registration information into the organizations information systems. Routinely review existing scheduling templates for future appointment availability in order to effectively schedule patients appointments. Answer telephone lines and make necessary patient accommodations in the Department of Ophthalmology or in the Keck Medical Center at USC. Provide information to callers regarding the Department and its patient care services. Correctly enter patients recalls for patients future visits in the appropriate practice management systems. For patients wishing to be seen in other geographic areas, make appointments with conveniently located clinical faculty. Appointment-making for the Roski Eye Institute includes obtaining pre-authorizations and other documentation, as appropriate. Other documentation may include, for example, eye notes from previous ophthalmic providers. Provide location and office hours of emergency services to patients who state they are experiencing an eye emergency.
• Administrative Duties Lead by example. Monitor staff in front office area, ensuring adherence to current policies and procedures as well as productivity benchmarks. Recognize common issues and recommend alternatives or changes to current process, training materials, knowledge bases, or job aids to resolve concerns or reduce impacts. Establish best practices throughout the support process. Work closely with internal and external support teams to create workflows which enhance and streamline the patient experience. Partner with management to develop and implement ongoing training programs to address the needs of the department. Serve as the point person for new employee orientation and ongoing communications with team members to ensure consistency with Roski Eye Communications Center (RECC) best practices and benchmarks. Identify opportunities for improvement and, when appropriate, collaborate with supervisor to develop and implement effective solutions. Triage patient issues to achieve timely resolution. Resolve patient problems related to such matters as billing, coordination of patient tests, appointments, and/or medical records. Respond to patient messages and/or voicemails, same day. Respond to requests by doctors and technical staff during clinic. Make phone-calls as requested and obtain records as needed. For cancellations and no-shows, follow appropriate steps as per policy. Maintain clinic/patient flow, balancing patient registration requirements, patient appointment times, and non-appointment activities. Serve as a liaison between outpatient clinics and programs in administrative matters. Help to maintain a therapeutic atmosphere by providing a supportive interface between patients, providers, and staff. Assist providers in performing schedule changes. Review active worklist(s) and address patient account needs. Always maintain and protect patient confidentiality. Keep patient reception area(s) organized and neat. Maintain adequate levels of front office supplies. Support and participate in department huddles and team meetings.
• Perform other duties or projects, as assigned, or requested.

Required Qualifications:

• Req High school or equivalent Or equivalent evidence in file required.

• Req 2 years Experience in customer service.
• Req 2 years Experience with an electronic medical record (EMR)
• Req 1 - 2 years Experience in a Lead Front Office role
• Req Experience scheduling patient appointments in computerized appointment scheduling system.

• Req Working knowledge of basic medical terminology and diseases, as it applies to the eye.
• Req Strong organizational and follow-up skills.
• Req Experience scheduling patient appointments in computerized appointment scheduling system.
• Req Knowledge and proficiency with insurance.
• Req Strong insurance verification and pre-registration background.
• Req Knowledge of Medical/CCS billing/authorization guidelines.
• Req Demonstrate strong oral and written communication skills.
• Req Sufficient computer keyboard skills to perform appointment scheduling, encountering, emailing, and other related computer tasks.
• Req Excellent interpersonal skills which promote pleasant and effective communication with patients, staff, and doctors.
• Req Demonstrate professional and effective work skills to handle all responsibilities within a fast-paced, high pressure setting.
• Req Ability to work independently with minimal supervision.
• Req Ability to multitask effectively.
• Req Flexibility and adaptability given the dynamic nature of medicine and departmental needs.
• Req The ability to interact calmly and effectively with patients with difficult personalities.

Preferred Qualifications:

• Pref 2 years Experience in ophthalmology practice setting.
• Pref 2 years Experience working in a medical teaching institution.
• Pref Experience in medical admission setting.
• Pref 3-5 years Experience with an electronic medical record (EMR).

Required Licenses/Certifications:

• Req Fire Life Safety Training (LA City) If no card upon hire, one must be obtained within 30 days of hire and maintained by renewal before expiration date. (Required within LA City only)

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About University of Southern California (USC)

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