Patient Services Representative II - Primary Care Wayne, PA

Nemours Foundation Wayne , PA 19080

Posted 2 months ago

As one of the nation's leading pediatric health care systems, Nemours is committed to providing all children with their best chance to grow up healthy. We offer integrated, family-centered care to more than 300,000 children each year in our pediatric hospitals, specialty clinics and primary care practices in Delaware, Florida, Maryland, New Jersey and Pennsylvania. Nemours strives to ensure a healthier tomorrow for all children - even those who may never enter our doors - through our world-changing research, education and advocacy efforts. At Nemours, our Associates help us deliver on the promise we make to every family we have the privilege of serving: to treat their child as if they were our own.

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 team environment. All Nemours associates are expected to ensure that these philosophies are embedded in their day to day work with colleagues, patients and families.

Primary Function: Receive inbound calls, collect accurate demographic/verify insurance information, accurately document the system, schedules the appointment, Make outbound scheduling calls, collect funds as needed, complete administrative work as assigned

This is a 32 hours a week full-time role.

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.

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

  • Reviews essential patient appointment information, i.e. location of appt, NPO, bring all meds to appt., prep information

  • Process requests for prescription refills

  • 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 eReferral external physicians requests for appointment scheduling.

  • Processes incoming staff messages by supporting the MyNemours 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, HIPPA, corporate compliance, and bioterrorism

  • Assist with making discharge follow up calls


High School Diploma

More than 1 and up to 3 years of job related training.

Our dedication to professionals who are dedicated to children frequently earns Nemours a spot on the list of top workplaces in the communities we serve. Our Associates enjoy comprehensive benefits, including our unique "Bridge to a Healthy Future" pediatric health plan, an integrated wellness program, opportunities for professional growth, and much more. As an equal opportunity employer, Nemours focuses on the best-qualified applicants for our openings.

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Patient Services Representative II - Primary Care Wayne, PA

Nemours Foundation