Job Details

We are an FQHC community health center dedicated to embodying the values central to American Indian cultures. This includes respect for our patients, acknowledgement of the whole person, and a focus on working together to ensure health for the individual, and therefore the community. We invite persons of all tribes, ethnic backgrounds and walks of life to experience the comprehensive care we deliver and to contribute to the services we provide for children, youth, families, adults, and elders.

The Patient Services Representative (PSR) plays a vital role in ensuring timely patient access to high-quality medical, behavioral health, and dental services at San Diego American Indian Health Center. This position is responsible for delivering exceptional customer service while supporting front desk and call center operations, including patient registration, appointment scheduling, insurance verification, and care coordination.

As the first point of contact, the PSR creates a welcoming, efficient, and culturally responsive environment for all patients. This role ensures accurate data collection, clear communication of financial responsibilities, and proper documentationwithin the Electronic Health Record (EHR).

The PSR contributes to overall clinic performance by maintaining scheduling accuracy, verifying complete and up-to-date patient demographic and insurance information at every encounter, and meeting call performance standards, including maintaining a call abandonment rate below 7%.

In addition to core responsibilities, the PSR performs a variety of administrative and clerical tasks to support the efficient daily operations of the medical department. The individual must demonstrate the knowledge, skills, and abilities required to perform all job-related responsibilities effectively.

Essential Duties and Responsibilities:

Primary Functions:

1. Greet patients in a courteous, respectful, and professional manner while maintaining a clean, safe, and welcoming reception area.
2. Complete new patient registration in accordance with billing, compliance, and medical records guidelines.
3. Accurately verify and enter patient demographic and insurance information, ensuring all required clinical and administrative documents are collected, scanned, and properly documented in the Electronic Health Record (EHR).
4. Screen and process applications for applicable programs (e.g., CHDP, EWW, FPACT, SFS, RHAP) and ensure correct entry of clinical codes during patient check-in.
5. Collect and document patient information for walk-in triage, including patient identifiers, chief complaint, and payer source, while verifying insurance eligibility and required documentation.
6. Collect co-pays, outstanding balances, and payments at the time of service, providing accurate receipts in accordance with fiscal policies and procedures.
7. Schedule, reschedule, and cancel patient appointments in alignment with provider templates and medical department scheduling guidelines.
8. Answer incoming calls and manage appointment requests in a timely and professional manner, ensuring all voicemails and return calls are completed per established workflows.
9. Maintain accurate and up-to-date schedules throughout the day, including patient status updates, no-show documentation, and timely check-in/check-out processes.
10. Perform end-of-day duties, including reconciliation of payments, verification of receipts, and completion of required front desk tasks.
11. Ensure front office supplies and required forms are stocked and prepared for the next business day.
12. Rotate coverage across Medical, Dental, and Behavioral Health front desks as assigned to support clinic operations.
13. Verify insurance eligibility and benefits, including co-pays, deductibles, and PCP assignments, and communicate financial responsibilities clearly to patients prior to services.
14. Ensure appointments are scheduled accurately according to established guidelines and that PCP assignments and insurance information are correct.
15. Review EHR and scheduling systems (eCW) to identify and complete outstanding administrative and clinical requirements, including required documentation such as identification, insurance cards, and program applications.
16. Request and coordinate retrieval of paper charts from medical records as needed in accordance with policy.
17. Ensure payer source information is accurate, properly sequenced, and aligned with billing requirements for each date of service.
18. Scan and upload insurance verification documentation into the EHR, ensuring clarity, accuracy, and correct indexing.
19. Support clinic productivity by contacting patients from waiting lists to fill open appointment slots and optimize provider schedules.
20. Perform additional duties as assigned to support clinic operations and patient care delivery.

Qualifications:

Minimum Qualifications:

To successfully perform this job, the individual must be able to fulfill each essential duty and responsibility outlined in this position with performance standards. The qualifications listed below represent the necessary knowledge, skill and ability required.

1. High School Diploma or GED (equivalent).
2. 2-3 years related experience and/or training, or equivalent combination of education and experience.

Preferred:

1. Experience serving a multinational, multicultural population.
2. FQHC background.

1. Familiarity with Community Health Clinics and/or Indian Health Clinics.

1. ECW EHR.

Special Conditions of Employment:

1. CPR/ BLS certification: Maintain a current Basic Life Support (BLS) certification issued by the American Heart Association (AHA), the American Red Cross, or an equivalent organization. Certification must include an in-person, hands-on skills assessment. Online-only certifications are not accepted.
2. Annual background checks: Consent to annual background checks as a condition of continued employment, to ensure compliance with organizational standards and eligibility requirements.
3. For-Cause Drug Screening: Comply with drug screening requirements when initiated by the organization for cause, to support a safe, compliant, and drug-free workplace.
4. Ongoing Compliance Requirements: Maintain up-to-date compliance with all required annual renewals, including professional licenses, certifications, physical examinations, TB testing, and mandatory regulatory trainings as assigned by the San Diego American Indian Health Center (SDAIHC).
5. Work Schedule: Monday - Friday 8:00am - 5:00pm

Knowledge, Skills, and Abilities:

1. Demonstrates strong verbal and written communication skills, with the ability to communicate clearly and professionally across all levels.
2. Exhibits excellent time management skills with the ability to prioritize tasks and meet deadlines in a fast-paced environment.
3. Maintains a high level of organization, accuracy, and attention to detail in all aspects of work.
4. Demonstrates the ability to maintain strict confidentiality while ensuring accurate documentation and record-keeping.
5. Possesses strong interpersonal skills and the ability to interact effectively with diverse populations.
6. Builds and maintains cooperative working relationships with patients, staff, and leadership.
7. Applies basic mathematical skills to support job responsibilities, including payment processing and reconciliation.
8. Demonstrates reliability, accountability, and a high level of trustworthiness.
9. Proficient in Microsoft Office Suite or equivalent software programs, with the ability to learn new systems efficiently.

Physical and Mental Requirements:

Physical demands outlined below represent those required to successfully perform the essential functions of this job, without accommodation.

Physical and Mental Requirements: continue

1. Ability to lift and move up to 10 pounds and navigate between locations as needed.
2. Capability to remain seated at a desk and operate a computer for extended periods.
3. Physical stamina to stand, bend, and reach for prolonged durations.
4. Strong analytical skills, with the ability to perform mathematical calculations, organize and prioritize tasks, and maintain productivity under pressure.
5. Demonstrated ability to supervise, manage multiple tasks simultaneously, and comprehend and follow instructions accurately.

Customer Service:

1. Actively champions and upholds the Mission, Vision, and core values of SDAIHC through consistent actions and commitment.
2. Demonstrates outstanding customer service in all interactions with internal and external stakeholders, fostering positive and respectful relationships.
3. Embodies SDAIHC's Standards of Customer Service Behavior, including Compassion, Positive attitude, Effective Communication, Professional Appearance, a Strong Sense of Ownership, and Collaborative Teamwork.
4. Continuously engages in customer service training and professional development to enhance skills and maintain best practices.
5. Proactively promotes SDAIHC's reputation as a leading service organization through every interaction, demonstrating professionalism and dedication.

Quality Management:

1. Actively contributes to the organization's success by engaging in quality improvement initiatives and demonstrating a commitment to continuous enhancement of services.
2. Strictly adhere to all SDAIHC policies and procedures while proactively supporting the adoption and implementation of new organizational initiatives.
3. Participate in and champion ongoing quality improvement efforts as directed by clinic leadership, fostering a culture of excellence and innovation.

Safety:

1. Maintain strict compliance with all regulations, policies, and procedures related to safe work practices, consistently prioritizing workplace safety.
2. Actively engage in infection prevention by adhering to best practices and implementing appropriate infection control measures during patient care and interactions.
3. Ensure full compliance with regulatory standards to maintain the safety of the physical environment, including equipment and supplies, promoting a secure and hazard-free workspace.
4. Utilize all necessary tools and equipment effectively to uphold workplace safety and reduce potential risks.
5. Promptly identify and report any unsafe working conditions to ensure immediate corrective action and maintain a safe working environment.

Privacy/Compliance:

1. Upholds the highest standards of privacy and security for all patients, employees, and volunteers by strictly granting access to information solely on a need-to-know basis for legitimate business purposes.
2. Demonstrates unwavering commitment to corporate integrity by adhering to all relevant regulations and promptly reporting any unethical, fraudulent, or unlawful behavior or activities.
3. Consistently exemplifies the highest ethical standards in all professional interactions and decision-making processes.
4. Safeguards the confidentiality and security of patient and employee information with the utmost integrity, maintaining trust and accountability by allowing access strictly for business-related needs.

Disclaimer

Nothing in this job description restricts management's right to assign or reassign duties and responsibilities to this job at any time. This description reflects managements' assignment of essential functions. It does not prescribe or restrict the tasks that may be assigned. This job description is subject to change at any time.

Preference is given to qualified American Indian/Alaskan Natives in accordance with the American Indian Preference Act (Title 25, U.S. Code Section 472, 473 and 473a). In other than the above, the San Diego American Indian Health Center, is an equal opportunity employer.

Acknowledgement

San Diego American Indian Health Center is an Equal Opportunity Employer. We encourage applications from all individuals regardless of race, religion, color, sex, pregnancy, national origin, sexual orientation, gender identity, gender expression, ancestry, age, marital status, physical or mental disability or any other protected class, political affiliation, or belief.

Preference is given to qualified American Indian/Alaskan Natives in accordance with the American Indian Preference Act (Title 25, U.S. Code Section 472, 473 and 473a). In other than the above, the San Diego American Indian Health Center, is an equal opportunity employer.

San Diego American Indian Health Center is an Equal Opportunity Employer. We encourage applications from all individuals regardless of race, religion, color, sex, pregnancy, national origin, sexual orientation, gender identity, gender expression, ancestry, age, marital status, physical or mental disability or any other protected class, political affiliation, or belief.