Patient Services Representative II

Description

Position Summary: 

Provides exceptional customer service by answering phone calls and ensuring patient needs are met with care and efficiency. Handles variety of call types while representing the company's commitment to quality, compassion, and support.

Essential Functions and Job Responsibilities: 

LEVEL 1 - Patient Service Representative

• Answers calls and emails in timely manner, meeting performance goals
• Handles standard call types: tank requests, ETA inquiries, pick-up requests, location assistance, order status, pricing inquiries
• Documents call information per standard operating procedures
• Answers questions about products, services, retail stores, and general service information
• Verifies insurance carriers in database system
• Resolves customer complaints with problem-solving approach
• Maintains working knowledge of current products and services
• Adheres to HIPAA guidelines and maintains patient confidentiality

LEVEL 2 - Patient Service Representative

All Level 1 duties plus:

• Handles advanced call types: oxygen (O2) services, DME, insurance verification/clarification
• Processes payments, orders, and returns
• Troubleshoots equipment issues and provides advanced care solutions
• Resolves escalated issues or hands off with clear documentation
• Serves as resource to Level 1 representatives for knowledge sharing and skill development

LEVEL 3 – Lead, Patient Service Representative

All Level 1 and 2 duties plus:

• Serves as subject matter expert and primary resource for team
• Conducts new hire training and mentors team members
• Handles escalated calls and complex issues with appropriate follow-up
• Identifies root causes of service issues and collaborates on process improvements
• Prepares reports for leadership and other departments
• Supports departmental standards and Patient Experience initiatives
• Assists with task coordination and ensures adherence to workflows
• Collaborates with supervisor on performance metrics and service excellence

Competency, Skills and Abilities: 

Customer Service & Communication

• Deliver exceptional customer service with empathy, patience, and professionalism
• Demonstrate active listening and clear verbal/written communication skills
• Effectively address patient needs, concerns, and inquiries

Technical Proficiency

• Strong problem-solving and analytical thinking abilities
• High attention to detail in documentation and data verification
• Proficient in computers, Microsoft Office, and database systems
• Excellent multitasking and prioritization in fast-paced environments

Professional Attributes

• High emotional intelligence to handle stressful situations with compassion
• Adaptable and flexible with changing processes and technologies
• Self-motivated with ability to work independently and take initiative
• Strong team collaboration and cooperative work style
• Commitment to continuous learning and professional development

Healthcare Knowledge

• Familiarity with Medicare, Medicaid, and commercial insurance processes (preferred)
• Understanding of healthcare documentation requirements

Compliance & Confidentiality

• Strict adherence to HIPAA regulations and patient confidentiality
• Full compliance with company policies and referral guidelines

Requirements

Education and Experience Requirements:

• High school diploma or equivalent required
• Associate’s degree in healthcare administration, Business Administration, or related field preferred
• Previous experience in healthcare, insurance, medical billing, or patient services preferred.
• Knowledge of respiratory therapy or DME services preferred.
• Level I: (Entry Level):

One (1) year of work-related experience

• Level II: 

One (1) year of work-related experience plus

Two (2) years exact job experience

• Lead Level:

One (1) year of work-related experience plus

Four (4) years exact job experience

Physical Demands and Work Environment:

Physical Requirements

• Ability to sit for extended periods with prolonged computer screen exposure
• Must be able to bend, stoop, stretch, stand, and move between sitting/standing positions
• Perform repetitive hand, wrist, and finger motions due to extensive computer and phone use
• Occasional lifting of 5-10 pounds as needed
• Clear speech, hearing ability, and manual dexterity required

Work Environment

• High-volume call center environment with fluctuating stress levels
• Extended computer and telephone use throughout workday
• Potential exposure to angry or upset customers/patients
• Possible exposure to hazardous materials, loud noise, temperature extremes
• Risk of contact with airborne, bloodborne, or other infectious pathogens

Mental and Communication Demands

• Maintain mental alertness to perform essential job functions
• Demonstrate empathy, compassion, courtesy, and respect for patient privacy
• Effective verbal and written communication skills required

Schedule Requirements

• Flexible scheduling to support business hours and after-hours programs as needed
• Adaptability to varying work levels and office activity fluctuations