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Providence Health & Services Lead, Patient Care Representative in Redondo Beach, California


Providence is calling a Lead, Patient Care Representative (Full Time, Day Shift) at Providence Medical Institute in Redondo Beach, CA.

We are seeking a Lead, Patient Care Representative who will be responsible for the supervision of patient management, including the flow of patients through the front office in an efficient and professional manner, the accurate coding of services rendered and over the counter cash management. Serve as a first line resource for Patient Care Representative I, II and III by being a role model to staff members

In this position you will:

  • Answer phones promptly. Screen and direct phone calls appropriately. Timely response to routine inquiries. Take accurate and complete messages and forwards messages promptly and accurately

  • Schedule patients in a timely and accurate manner and inputs patient demographic information into computer system, where applicable

  • Complete patient check in process. This includes:

  • Ensure patients sign the Sign in Sheet

  • Verify/update or has patient complete new Patient Registration Form

  • Collect and ensure accurate insurance and demographic information

  • Copy Insurance card.

  • Initial Patient Registration Form and superbill to confirm completeness of insurance information.

  • Collect patient co-payments

  • Complete patient check out process. This includes:

  • Maximize collections by following department policies and procedures

  • Review the patient superbill for completeness of services rendered, diagnosis, follow up instructions and scheduling next appointment or completing patient recall card

  • Obtain necessary information to complete authorizations as directed by the insurance requirements and the physician/provider Maintain authorization log and notifies patient of receipt of authorization within twenty four hours. Notifies physician/provider of any denials

  • Maintain an orderly and pleasing work space that ensures the integrity and safety of the practice, patients and personnel

  • Be responsible for accurate coding and batching of services rendered. Prepare paperwork, including accurate completion of Batch Summary Form and submits within forty eight hours the completed required information to the Central Billing Office.

  • Be responsible for maximizing collection of all over the counter payments due at time of Service. This may include co-payments, deductibles, uninsured and patient balances. Manage received cash by adhering to the department policy and procedure cash on cash control

  • Be responsible for supervising and training front office staff, including patient care rep I, II and III. Supervision includes coordinating job functions, contributing to designated staff performance reviews, first line disciplinary actions, staffing

  • Intervene with customers in difficult or non-routine matters. Be responsible for communicating to supervisor general and non-routine front office duties. Responsible for the management of physician schedules.

  • Scan and link text/images in Electronic Medical Record

  • Be responsible for timely and accurate verification of patient insurance and demographic information and ensures the communication of this information to the appropriate staff

  • Serve as liaison with employers for worker’s compensation and employer bulk and MILCM, to facilitate workflow and customer service

  • Be responsible for completing worker’s compensation first reports and status reports

  • Be responsible for reporting status of diagnostic/specialty services ordered by rendering physician at the site in a timely manner, as specified by supervisor

  • Be responsible for maintaining and documenting an appropriate inventory of front office supplies

  • Be responsible for completing specialty services batching accurately and timely

  • Be responsible for “Rounding with Purpose” and being the Patient Advocate

  • Documentation/Information Management:

  • Utilize MIS systems according to policy and procedure

  • Appropriate care and maintenance of MIS system needs to be observed at all times

  • Performance Improvement:

  • Participate in CQI and/or quality management activities as identified by supervisor

  • Development:

  • Keep abreast of department policies and procedures by positively participating in staff meeting and inservices. Participate in at least one Human Resource Education Program per year

  • Budgetary:

  • Be responsible to use equipment and supplies efficiently and to make suggestions for cost cutting initiatives to supervisor


Required qualifications:

  • Four (4) years experience in medical office

  • Knowledge of ICD-9 / CPT Coding

  • Able to use Microsoft Office Suite

  • Typing / keyboarding skills of 45 WPM

Preferred qualifications:

  • One (1) year of supervisory experience

About the ministry you will serve:

Providence Health & Services Southern California is further developing its physician integration strategy. Historically, the largest asset has been Providence Medical Institute, a medical foundation that provides administrative and other support services to affiliated medical groups. Providence Medical Institute is expected to grow significantly in the next several years, bringing with it facilities, staff and physician growth to support that objective.

Benefits and Retirement:

Do you have questions on how this position may impact your benefits or retirement? AskHR has answers! Contact the HR Service Center at 888-687-3753, submit an AskHR through the HRPortal; or visit the Road2Retirement site; .

Caring for Your Career:

We are delighted that you answered the call to further your career at Providence. As a current caregiver, you have many resources to develop your skills and career such as educational benefits, online training, and professional development events. We encourage you to take advantage of these resources activities so that we can continue to serve our communities together with excellence. Our hope is that you continue to answer the call to our mission-inspired work today and into the future!

We offer a full comprehensive range of benefits - see our website for details

Our Mission

As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.

About Us

Providence Health & Services is a not-for-profit Catholic network of hospitals, care centers, health plans, physicians, clinics, home health care and services guided by a Mission of caring the Sisters of Providence began over 160 years ago. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.

Schedule: Full-time

Shift: Day

Job Category: Patient Services

Location: California-Redondo Beach

Req ID: 249101