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Luhs_service Representative_3057

The Ambulatory Service Representative promotes increased utilization of Loyola services by maintaining a customer service attitude that reflects the mission, vision and values of Loyola Medicine. The individual ensures effective clerical operations for the service area and performs all job duties under the highest customer service standards to exceed customer expectations. Always conveys a professional and positive image of Loyola Medicine during interactions with patients, families, physicians, staff members and internal departments.
FRONT OFFICE - Demonstrates ownership of front office and interacts with patients and family members in a professional and welcoming manner according to established guidelines and procedures. a.) Utilizes protocol established for greeting patients at check in and servicing patients during the check out procedure. b.) Monitors wait time of patient. Keeps abreast of schedule delays and when necessary, informs patient of anticipated timeframe for service. c.) Adheres to Loyola's code of ethics and corporate compliance program related to patient privacy and safety concerns. d.) Monitors patient waiting area and actively assume responsibility to ensure a clean and organized environment is maintained. Takes initiative to refer environmental improvements to the appropriate departments (PPG, outside services, etc.).
REGISTRATION - Utilizes and is proficient in registration software system in accordance with ambulatory, LUMC and LUPF guidelines to secure accurate demographic and insurance data. a.) Compares and verifies patient demographic and insurance information with system data to ensure accuracy. b.) Ensures that accurate insurance card is scanned into system. c.) If revisions are needed to insurance or demographic information, enters the new data in the system or ensures all data is collected and given to registration specialist to update. d.) Secures identification from patient (driver's license) and scans into system. e.) Secures consent and HIPPA documentation from patient and indicates date received in system. f.) Obtains referral form or waiver form from patient as appropriate and notifies physician. g.) Creates HAR with appropriate insurance and guarantor information for visit. Secures all information that is identified as missing during the HAR creation. h.) Utilizes patient FYI to communicate status or action taken related to insurance or patient activity.
INSURANCE VERIFICATION - Utilizes insurance verification procedures to ensure maximum reimbursement and correct payment. a.) Responsible for maintaining knowledge of insurance status and benefits. Continuously updates knowledge by attending educational forums and reading appropriate written communications. b.) Collects appropriate co-pay, or co-insurance for visit. c.) Informs patient of self pay status and follow policy protocol. d.) Maintains registration requirements for overall and plan code accuracy.
SCHEDULING - Utilizes and is proficient in scheduling software system in accordance with system and physician guidelines to effectively schedule, cancel and revise appointments. a.) Schedules patient appointments in conjunction with orders, urgency of care and patient convenience, involving multiple sites when appropriate. Ensures that patient is offered services at location and time that is most convenient, while maintaining physician protocol. b.) Offers wait list to patients that are scheduled over 14 days. c.) Ensures that new patient appointment information is obtained at time of scheduling appointment. If missing, follows up with patient prior to visit to secure data. d.) Cancels clinic patient appointments as necessary. Responsible that all patients are notified and rescheduled in a timely manner. e.) Documents no-shows and cancellations in scheduling software system. f.) Monitors physicians' schedules daily for optimal physician schedule and patient satisfaction. Contacts patients on wait list and offers earlier appointment when appropriate.
GENERAL CLINIC PROCEDURES- Ensures efficient day-to-day operations. a.) Precepts, coaches and mentors new employees. b.) Processes files and documents related to patient care and appointments, including faxes and/or medical records from outside institutions. c.) Maintains logs, departmental statistical data, and schedules as required. d.) Proactively addresses and resolves issues using appropriate resources. e.) Complies with physician protocols established in the clinics. f.) Coordinates physician surgery schedules as required by their service area.


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