The Patient Support Specialist is responsible for accurately performing activities related to the smooth functioning of the Recuperative Care Department, including all clerical aspects of patient services to ensure completeness and continuity of care. The person in this role is responsible for in person and telephone communications between patients, external service providers and the facility. He/She will provide application assistance to underinsured and uninsured patients of Qualified Health Plans and insurance affordability programs including MassHealth and insurance programs offered through the Health Insurance Exchange (HIX). He/She interviews, assesses and screens patients for eligibility for qualified health and dental plans and assist with enrollment and account management; they will track and process accurate, complete and timely applications with regards to Lynn Community Health Center processes and procedures and consistent with the Certified Application Counselor Designation Agreement. The Patient Support Specialist works closely with patients, families, and the care team to ensure timely access to specialty and diagnostic imaging referrals. The PSS is responsible for greeting patients in a friendly and professional manner and helping them to receive the services they need. For patients with appointments, duties include completing initial registration, updating demographic and insurance information at every encounter, generating encounter forms, and alerting clinical staff that the patient is ready. For patients without appointments, ensure that they are able to speak with appropriate clinical staff. He/She is also responsible for answering telephones, taking accurate and complete messages, and helping callers to get the correct information they need. He/She is responsible for making telephone and in-person appointments for patients. He/she will be assigned to support members of the Reception/Appointment Staff with questions and/or concerns related to registration and customer service activities. This fast-paced position requires a high level of independence, attention to detail and flexibility.
SPECIFIC DUTIES AND RESPONSIBILITIES:
- Respect and maintain patient confidentiality in all aspects of care including use of electronic information.
- Treat all patients in a welcoming and professional manner.
- Demonstrate professionalism by appropriate attire, attendance, attitude, and behavior within the clinical setting.
- Contribute to the team effort by supporting all team members and maintaining an open and positive attitude.
- Welcome new employees to the team by assisting with their orientation to the team and mentoring them, as requested.
DUTIES AND RESPONSIBILITIES:
- Maintain ongoing tracking and appropriate documentation on patient referrals to promote team awareness and ensure patient safety.
- Ensure complete and accurate registration, including patient demographic and current insurance information.
- Assemble information concerning patient’s clinical background and referral needs.
- Per referral guidelines, provide appropriate clinical information to specialist.
- Contact review organizations and insurance companies to ensure prior approval requirements are met.
- Present necessary medical information such as history, diagnosis and prognosis.
- Review details and expectations about the referral with patients.
- Assist patients in problem solving potential issues related to the health care system, financial or social barriers (e.g., request interpreters as appropriate, transportation services or prescription assistance).
- Be the system navigator and point of contact for patients and families, with patients and families having direct access for asking questions and raising concerns. May assume advocate role on the patient’s behalf with the carrier to ensure approval of the necessary supplies/services for the patient in a timely fashion.
- Establish and maintain relationships with identified service providers.
- Ensure that referrals are addressed in a timely manner.
- Remind patients of scheduled appointments, according to patient’s preferences.
- Ensure that patient’s primary care chart is up to date with information on specialist consults, hospitalizations, ER visits and community organization related to their health.
- Continually monitor appointment schedule, acknowledge appointments, and change appointment status for cancels
- Monitor Waiting Room to insure patients are being taken care of in a timely manner.
- Other duties deemed necessary or appropriate by Supervisor in order to ensure efficient flow of patients through the health center
- Attends monthly department meetings.
- Provides information about full range of medical and dental insurance programs available through the Health Insurance Exchange (HIX).
- Answers questions about the Qualified Health Plans (QHP) and Qualified Dental Plans (QDP).
- Interviews patients and utilizes a mathematical formula to determine eligibility for subsidized health assistance programs.
- Effectively communicates enrollment eligibility in a manner that is easily understood by patients.
- Assists patients with completing applications and renewals and identifies the documentation required for the health exchange to determine insurance eligibility.
- Informs applicant of important deadlines, coverage dates, etc.
- Assists patients with selecting or changing insurance plans; answers questions about plan benefits including but not limited to out-of-pocket expense, co-pays and deductibles.
- Demonstrates an understanding of customer service principles by successfully completing on-line Customer Service training.
- Utilizes the principles of customer service when interacting with patients/clients, team members and staff from other departments.
- Appropriately handles or seeks support when customer service breakdowns occur.
- Demonstrates knowledge of culture by successfully completing the on-line training on Cultural Competence.
- Utilizes an appreciation of and respect for diversity when interacting with patients/clients, team members and staff from other departments.
- Responds appropriately or seeks support when confronted with cultural biases or conflicts.
- Is aware that in order to respond promptly and appropriately to emergencies, any staff member may be assigned duties that differ from those in the job description or may be assigned temporarily to a different location or schedule.
- Understands that all staff should have a Personal Emergency Plan in place to best respond to his/her job responsibilities should health center emergency arise.
- The Patient Support Specialist will possess a high school diploma or equivalent and have strong organizational skills with demonstrated proficiency in computer applications (Microsoft Office, EPIC).
- Knowledge of EPIC, preferred.
- Graduate of a medical secretary program, preferred. Associates or Bachelor’s degree is a plus.
- Excellent communication skills (written and oral) professional demeanor, good problem-solving skills, organized and detail-oriented
- Understanding of Medicare, Medicaid and managed health care plans are necessary qualifications for this position.
- English / Spanish bilingual ability is preferred.
- Ability to communicate effectively with a diverse patient population.
- Pleasant telephone manner
- Ability to be courteous, efficient, effective, and patient under hectic circumstances
- Complete the 10-hour ACA enrollment training and be certified as a Certified Application Counselor within 45 days of employment and maintain certification.
- History of good attendance and positive work attitude
- Minimum of two years of Customer Service experience or equivalent combination of education and experience.
- The essential duties of this position present risk of exposure to airborne infection, body fluids, and blood-borne pathogen. Annual BBP Training is required.
- Up to date immunization and annual TB testing is required. Hepatitis B vaccine and annual flu immunization are strongly recommended. All necessary vaccines are available at no charge at the health center. A Declination form must be signed if the Hepatitis B or other recommended vaccines are declined.
Lynn Community Health Center (LCHC) provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, LCHC complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, and transfer, leaves of absence, compensation and training. LCHC expressly prohibits any form of workplace harassment based on race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status. Improper interference with the ability of LCHC’s employees to perform their job duties may result in discipline up to and including discharge
Job Posting ID # 18-122 (30 Hours)