Patient Services Specialist (PSS)

The mission of Correctional Managed Care is to address the healthcare needs of underserved patient populations within the Texas Department of Criminal Justice (TDCJ) and the Texas Juvenile Justice Department (TJJD).

JOB SUMMARY:

Has advanced Patient Services Specialist skills and is proficient in independently maintaining a positive patient experience by consistently exceeding expectations in customer service and patient care, by coordinating clerical and medical activities of a healthcare team, patient registration activities and facilitating access to UTMB services for new and returning patients.

ESSENTIAL JOB FUNCTIONS:

LEAD RESPONSIBILITIES:

• Ability to function as a team leader.
• Provides peer guidance and leadership.
• Able to effectively triage problems.
• Understand clinic flow to maximize clinic usage to meet patient needs.

CUSTOMER SERVICE:

• Provides high level customer service in all interactions with internal and external customers.
• Provides direct, professional, and knowledgeable interactions with patients, physicians, referral sources, and the treatment team.
• Answers calls accurately and with exceptional customer service at all times.
• Ensures caller's needs are met and accurate information is obtained.
• Ensures calls are documented and triaged appropriately ensuring patient satisfaction and patient safety.
• Acts as patient advocate and liaisons with various departments to meet mutual goals.
• Maintains patient confidentiality regarding access to patient and other clinical information via email, computer, fax and mail.
• Addresses concerns of patients, provides service recovery, and escalates issues as needed.

SCHEDULING:

• Applies the policies of the clinical entity to schedule appointments.
• Coordinates financial counseling for day surgery.
• Completes reminder calls to patient for scheduled appointments.
• Educates patient/responsible parties regarding billing process and any additional financial responsibilities including third party benefits information.
• Provides out-of-pocket cost estimates to patients.
• Counsels patients about unpaid bills.
• Obtains future appointments at time of service for clinic follow-up, referrals, and ancillary services.

ARRIVAL:

• Arrives patients and prepares paperwork/chart for visit.
• Appropriately receipts all monies collected, tokens, distributed, and deferments authorized.

REGISTRATION:

• Verifies, ensures eligibility, and pre-registers patients by obtaining patient demographics and third party coverage(s) at every encounter.
• Obtains and documents information required for third party coverage.
• Ensures compliance with Medicare and third party coverage.
• Communicates with patient, referral source, UTMB physician and clinical staff regarding and obstacle to access or authorization.

DISPOSITION:

• Fully dispositions each patient within the designated timeline.

MARGINAL OR PERIODIC JOB FUNCTIONS:

• Performs related duties as required.
• Reads all OSA Announcements and relevant communications relating to job duties.
• Successfully completes competency based training and testing on an annual basis.
• Prioritizes and completes all work in an accurate, effective and efficient manner.
• Participates in team meetings/activities and supports the philosophy and goals of the team/department.
• Adheres to internal controls and reporting structure established for department.
• Performs other duties as assigned.

EQUIPMENT:

Standard office equipment.

WORK ENVIRONMENT/LOCATION:

Standard hospital, clinical and/or office environment.

Security clearance is required; pre-employment drug testing is also required.