Under the direct supervision of the Customer Service Manager, the Patient Service Specialist (PSS III) provides exceptional customer service to all patients, customers, clients, co-workers and staff. The PSS III greets patients, customers and staff with a smile and acknowledges them when entering the clinic. PSS III covers all sites and service lines under the UCSD Manager. PSS III are required to meet Front Office metrics that include, patient full registration, eligibility confirmation, insurance card scanning, email collection and time of service collection. PSS III collect all UDS data, family size and income. PSS III runs eligibility for all patients and ensures the correct insurance is selected when creating claims. PSS III work on their assigned department buckets on a daily basis. Works closely with assigned providers and care team to ensure follow up care is completed.

Essential Functions:

• Completes all registrations in a professional, accurate and customer–oriented timely manner.
• Obtains information from patient health insurance or managed care identification card.
• Understands and consistently demonstrates daily compliance to standardized practices and procedures in all areas of cash collection, handling, and storage of cash funds-tills.
• Answers all incoming calls appropriately, as evidenced by Manager’s observation.
• Responds to calls from patients, physicians, physicians’ office staff, and peers, and uses good judgement to determine the urgency of the situation. Answers telephones for department, prioritizes, screens, and redirects calls. Answers questions, handles routine matters and takes messages.
• Schedules all appointments for patients on the scheduling system and works with the manager to meet these goals.
• Process requests for medical records from physicians, attorneys, legal agencies, insurance companies, governmental agencies, hospitals, Mass Pro, audits and former/current patients.
• Reviews and processes record requests to determine presence and accurate completion of authorization for release of information. Contacts patient, physician or other appropriate party in order to secure absent/inappropriate authorization.
• Receives and forwards faxed requests for medical information from various agencies.
• Processes medical records requests and verifies their identification and authorization.
• Maintains forms in all printers at all times, which may require lifting or carrying cases of forms. Must have knowledge of all software and hardware computerized equipment.
• Maintains strict confidentiality of all patient information and documentation.
• Demonstrates respect and regard for the dignity of all patients, families, visitors and fellow employees to ensure a professional, responsible, and courteous environment.
• Promotes effective working relations and works effectively as part of a department/unit team inter and intra departmentally to facilitate the department’s/unit’s ability to meet its goals and objectives.
• Attends all required Safety Training programs and can describe his/her responsibilities related to general safety, department/service safety, specific job-related hazards.
• Follows the Organization’s Exposure Control Plans/Bloodborne and Airborne Pathogens.
• Ability to carry out all other duties as assigned.

Minimum Education: High School Diploma/GED

Minimum Work Experience: 3+ years of experience in Medical/Dental/BHS and Specialty setting required. Strong organizational skills to allocate time between different duties and responsibilities. Fully cross-trained and capable of covering at any site and service line under UCSD Manager. Graduate of PSS II by completing training program or experience in healthcare or related settings required.

Required Licenses/Certifications: Current driver’s license and auto insurance. Yearly competency trainings for customer service, UDS/migrant and seasonal, insurance and sliding fee program.

Required Skills, Knowledge, and Abilities: Bilingual (English/Spanish) language skills. Exceptional customer service skills and telephone etiquette. Ability to complete assignments with minimal or no supervision. Demonstrates strong critical thinking and problem-solving skills. Ability to effectively organize and prioritize tasks in order to complete assignments within the time allotted and maintain standard.