Patient Services Rep II-Villanova Primary Care – Nemours – Wilmington, DE

Nemours is looking for a motivated patient services representative to join the team at the Villanova primary care office.

Provide service excellence to each patient and family by performing and completing designated business processes associated with an outpatient visit. At each outpatient visit, complete processes in an efficient fashion, ensuring that the patient and family are prepared for their outpatient appointment in a timely fashion. Also, ensure that all demographic and financial information is accurately verified in advance of the patient visit, and monitor the waiting room and work environment to ensure patient safety and high service levels.

Participate in Nemours programs for continuous quality, performance, and service improvement and work with department management to improve the services provided, through a team-based approach.Greets families according to Nemours Standards of Behavior and AIDET. Check-in/out patients for scheduled appointments, collects accurate demographic/insurance information and documents in the system, verify insurance eligibility, review copay and account balances, collect funds as needed, schedule appointments, make outbound scheduling/appointment and confirmation calls, complete administrative work as assigned

Essential Functions:

• Greets families according to Nemours Standards of Behavior and AIDET

• Accurately load/update patient demographics adhering to system warnings

• Accurately schedules patients and creates/completes referral shells according to Scheduling Reliable Method

• Submit electronic referral requests at time of scheduling

• Obtain/understand insurance information provided by callers and accurately load insurance into EPIC

• Understand how to read electronic response history to enter/update insurance changes in EPIC, i.e. co pays, capitation agreements, PPO plan vs. HMO plan, coverage effective dates etc.

• Make outbound calls to families to provide accurate insurance eligibility information for service requested and collect any prepayment/deposit fees for scheduled visits for requested service, i.e. collect OON/NONPAR deposits required prior to DOS

• Informs patients about current initiatives, i.e. online scheduling, evening clinics and telehealth appointments

• Reviews essential patient appointment information, i.e. location of appointment, Nemours APP (telehealth), bring all meds to appt., prep information, etc.

• Process incoming clinical requests from families- sick calls, prescription refills, clinical questions- to be routed to nursing triage staff

• Documents DAR notes were applicable

• Confirms referral requirements with caller

• Participate in daily huddles.

• Manages the CCR template exceptions work which includes cancelling, rescheduling and blocking provider templates as requested via the CCR ticket process.

• Manages the internal and external referral work queues.

• Manages the PCP ticket requests to verify and update PCP information for EPIC.

• Processes and completed incoming e-Referral external physicians requests for appointment scheduling.

• Processes incoming staff messages by supporting the Nemours APP website and the Access Center team.

• Works according to the Standard Reliable Method

• Offers process improvements opportunities via the daily huddle

• Completes mandatory in-service training yearly which includes but not limited to safety, infection control, HIPAA, corporate compliance, and bioterroris

• Knowledge and adherence to all Joint Commission Guidelines

Additional Requirements:

High School Diploma

1-3 years of patient check in experience required

Employer Description

As one of the nation’s premier pediatric health care systems, we’ve made a promise to do whatever it takes to prevent and treat even the most disabling childhood conditions. It’s a promise that extends beyond our nationally recognized clinical treatment to an entire integrated spectrum of research, advocacy, education, and prevention.

Equity, diversity, and inclusion guide our growth and strategy. We are looking for individuals who are passionate about, and committed to, leading efforts to provide culturally relevant care, reducing health disparities, and helping build a diverse and inclusive environment. All Nemours Associates are expected to ensure that these philosophies are embedded in their day to day work with colleagues, patients and families.

To learn more about Nemours and our commitment to treat every child as if they were our own, visit us at www.nemours.org