Medical - Patient Services Rep

This position serves as the Patient Services Supervisor for the Medical Department at the San Diego American Indian Health Center (SDAIHC). The role is responsible for overseeing daily front-office operations and ensuring the delivery of high-quality, patient-centered services in alignment with FQHC standards.

The Patient Services Supervisor provides leadership, guidance, and accountability to Patient Service Representatives/Referral Coordinator / Patient Engagement Coordinator ensuring consistent performance in patient engagement, including welcoming patients, managing incoming calls, patient registration, appointment scheduling, insurance verification, and clear communication of financial responsibilities.

A key responsibility of this position is overseeing the closed-loop referral process. The Supervisor monitors incoming and outgoing referrals to ensure all direct reports are working within the established referral workflow, referral statuses are updated accurately and on time, and no referrals are left unresolved or stalled in eClinicalWorks. The Supervisor ensures the team meets established response priority timelines (STAT, URGENT, and ROUTINE) and that documentation standards are consistently upheld.

The Supervisor is equally responsible for overseeing the Patient Engagement Coordinator’s outreach activities, ensuring that proactive patient contact is purposeful, consistent, and results driven. This includes monitoring that outreach efforts across missed appointments, overdue care, waitlists, and newly assigned patients are being executed on schedule and that patient conversations are effectively converted into booked appointments.

The Supervisor expectations and outcomes, holds the Patient Engagement Coordinator accountable to conversion and contact rate expectations, and provides coaching to improve the quality and effectiveness of patient-facing communications.

In collaboration with the Patient Services Manager, this position supports the implementation of department workflows, performance expectations, and process improvements to enhance operational efficiency and patient access. The Supervisor works closely with leadership to address staffing needs, monitor productivity, ensure compliance with organizational policies, and promote a positive and professional work environment.

This position ensures the accuracy and timely maintenance of patient information within the Resource and Patient Management System (eClinicalWorks) and the Electronic Health Record (EHR), including updates to demographics, required documentation, and administrative forms. The Supervisor also supports workflow efficiency, regulatory compliance, and continuity of care while performing and overseeing general clerical and administrative functions as needed.

Essential Duties and Responsibilities:

Primary Functions:

Supervisory & Leadership Responsibilities

1. Provides day-to-day oversight and direction to Patient Service Representatives, the Referral Coordinator, and the Patient Engagement Coordinator, ensuring all staff are performing their assigned duties in accordance with department workflows and organizational standards.
2. Monitors staff attendance, punctuality, and daily task completion; addresses performance concerns in a timely and documented manner.
3. Conducts regular one-on-one check-ins and team huddles to review priorities, address workflow barriers, and communicate updates from leadership.
4. Supports onboarding, training, and ongoing competency development of all direct reports.
5. Provides coaching, corrective action, and recognition in alignment with SDAIHC’s HR policies. 6. Serves as the first point of escalation for front desk, call center, referral, and patient engagement issues.
6. Identifies staffing gaps and communicates coverage needs to the Patient Services Manager proactively.

Referral Workflow Oversight

1. The Supervisor is responsible for ensuring the Referral Coordinator is executing and maintaining SDAIHC’s closed-loop referral process from order placement through PCP follow-up.

1. Oversight responsibilities include:

1. 1. Review the eCW Referral Coordinator inbox daily to confirm all incoming referrals have been claimed, assigned, and actioned within established priority timelines: STAT: within 24 hours • URGENT: within 72 hours • ROUTINE: within 14 days
   2.  Monitor referral statuses across all stages from initial intake and prior authorization through specialist scheduling, appointment confirmation, and loop closure to identify any stalled, aged, or unresolved referrals. 3. Ensure referral documentation in eCW is accurate and complete, including updates to status/sub-status, Notes tab entries, Structured Data tab dates, and Telephone Encounters created for providers.
   3. Verify that courtesy calls are being completed at each required stage and that patient availability, transportation needs, and language requirements are documented in eCW.
   4. Confirm that consult notes are uploaded to patient records and that PCP follow-up appointments are scheduled upon loop closure.
   5. Review no-show documentation and confirm appropriate re-coordination efforts are completed and recorded.
   6. Serve as the escalation point when referrals require provider correction, payer follow-up, or specialist redirection.
   7. Ensure HRSA compliance standards are maintained across all referral documentation, including date, time, method, and recipient of every communication.

Patient Engagement Coordinator Oversight

1. Monitor the Patient Engagement Coordinator’s assigned outreach lists to ensure timely follow-up on missed appointments, overdue care, referral scheduling, Behavioral Health waitlists, and newly assigned patients.
2. Verify that all patient outreach attempts, communication outcomes, and coordination notes are documented accurately in the EHR.
3. Ensure the Patient Engagement Coordinator is meeting engagement timelines and performance metrics, including call abandonment rates, scheduling accuracy, and same-day Tele-Encounter completion.
4. Provide guidance on resolving scheduling barriers, care navigation escalations, and patient access issues.
5. Ensure cross-training in PSR functions is maintained and that the Patient Engagement Coordinator provides operational support to the front desk as needed.

Primary Front Office Functions as a hands-on Supervisor

1. Greets patients in a courteous and respectful manner and maintains the receptionist area and patient lobby clean, safe, and comfortable for patients and visitors.
2. Processes new patient registration in accordance with billing and medical records guidelines.
3. Ensures verification and data entry of updated demographics and insurance information is completed; clinical and administrative forms and documents are completed and scanned; applications for medical programs such as CHDP/EWW/FPACT/SFS are screened and processed; and clinical codes are entered correctly during patient check.
4. Compiles patient information for RN triage by completing a triage slip (patient’s name, HRN #, DOB, chief complaint, payer source), verifies insurance eligibility and benefits, and obtains required administrative and clinical forms.
5. Collects payments for outstanding balances, co-pays, and services provided at the time of service and provides patients and the fiscal department with accurate receipts.
6. Makes next patient appointments in accordance with medical scheduling templates and scheduling guidelines established by the Medical Director.
7. Answers incoming calls; ensures appointment cancellations and rescheduling are completed in a timely manner; and ensures voicemail messages and return calls are completed promptly per front desk process and guidelines.
8. Maintains schedules updated with status throughout the business day; assures no-shows are coded; and ensures patients are checked in and out in a timely manner.
9. Performs end-of-day duties: double-checks receipts, cash reconciliation, and all manual work; completes check-off list; compiles scanned forms and submits packet to the Patient Services Manager for review.
10. Ensures front desk forms and front office supplies are fully stocked for the next business day.
11. Ensures the appointment report is scanned to fiscal by 10:00 AM the next business day. 12. Rotates medical front desk coverage as assigned.

Schedule Preparation:

1. Identifies patient payer sources, verifies insurance eligibility, and benefits and determines co-pays and deductibles, PCP changes needed, SFS notifications, and communicates to patients and front desk prior to appointment.
2. Ensure scheduled appointments are scheduled within scheduling guidelines, PCP assignments are accurate.

1. Completes administrative check offs by reviewing patient EHR, scheduling system (BMW) and identifies outstanding required administrative and clinical forms, administrative required documents such as native verifications, photo IDs, insurance cards and completion of SFS applications. Request paper chart from medical records as needed in accordance with medical records policy and guidelines.
2. Ensures data entry of payer source is accurate and updated to coincide with insurance verification, sequence patient’s payer sources on the date of service in accordance to billing guidelines.
3. Scans all insurance verification to EHR, edits creation date, and double checks for readability and accuracy.
4. Confirm appointments and documents appointment status in ECW appointment “info box”.
5. Provide the front desk with the next day’s medical printed schedules prior to the end of business day.
6. Ensure the medical schedules remain booked by calling patients from the “waiting list”.

To perform this job successfully, an individual must be able to perform each essential duty and responsibilities set forth in this position performance standard policy. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Ability to supervise the department to ensure everyone is in compliance and performing optimally the duties of their position.

Minimum Qualifications:

1. High School diploma or general education (GED). 
2. Two-three years related experience and/or training.

Preferred:

1. Experience serving a multicultural population.
2. FQHC and/or public health background.
3. Familiarity with Community Health Clinics and/or Indian Health Clinics

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 (including marijuana).

1. 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 Community Health Center (SDCHC).

Knowledge, Skills, and Abilities:

1. Demonstrates strong verbal and written communication skills, with the ability to convey information clearly and effectively across all levels of the organization.
2. Confident in leading meetings, facilitating group discussions, and presenting information to diverse audiences.
3. Exercises sound judgment and the ability to work independently while effectively prioritizing and delegating responsibilities.

Knowledge, Skills, and Abilities: (continue)

1. Exhibits strong time management skills, with the ability to manage multiple priorities and meet deadlines in a fast-paced environment.
2. Maintains a high level of organization and attention to detail, ensuring accuracy and consistency in all work.
3. Demonstrates effective interpersonal and leadership skills, fostering a positive and collaborative team environment.
4. Ability to work effectively with individuals from diverse backgrounds, promoting inclusivity and respect.
5. Establishes and maintains cooperative and professional working relationships across departments and with external stakeholders.
6. Demonstrates reliability, accountability, and integrity in all aspects of work and decision-making.
7. Proficient in Microsoft Office Suite and other relevant systems or software, including eClinicalWorks.
8. Working knowledge of closed-loop referral processes, referral status tracking, and eCW referral module functionality preferred.

Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job with or without accommodation.

    Physical and Mental Requirements:

1. Ability to exert up to 10 pounds of force occasionally and/or a negligible amount of force frequently to lift, carry, push, or pull objects, including routine bodily movement.
2. Ability to sit for extended periods while working at a desk and operating a computer.
3. Ability to ambulate as needed to perform job duties, including moving between work areas or departments.
4. Frequent use of hands, wrists, and fingers to operate a computer and standard office equipment, including telephones and printers.
5. Ability to occasionally ascend and descend stairs to access various areas of the facility.
6. Ability to organize, prioritize, and manage workload effectively, including working under pressure and meeting deadlines.
7. Ability to supervise staff, multitask, comprehend, and follow written and verbal instructions.

Customer Service:

1. Actively supports and promotes the Mission, Vision, and core values of SDAIHC in all interactions and responsibilities.

1. Delivers high-quality, professional customer service to both internal and external stakeholders, ensuring a positive and respectful experience.
2. Consistently demonstrates SDAIHC’s Standards of Customer Service Behavior, including Compassion, Positive Attitude, Effective Communication, Professional Appearance, Sense of Ownership, and Teamwork.
3. Participates in ongoing customer service training and applied skills to enhance service delivery.
4. Represents SDAIHC with professionalism and integrity, contributing to its reputation as a leading service-oriented organization.

Quality Management:

1. Contributes to organizational success by actively participating in quality improvement (QI) initiatives and performance improvement activities.
2. Adheres to all SDAIHC policies and procedures and supports the effective implementation of new programs, workflows, and organizational initiatives.
3. Actively participates in and supports continuous quality improvement processes, ensuring alignment with clinic leadership direction and regulatory standards.  

Safety:

1. Maintains compliance with all regulatory requirements, policies, and procedures related to safe work practices.
2. Adheres to infection prevention and control protocols, including appropriate use of personal protective equipment (PPE) during patient care and interactions.
3. Ensures that physical spaces, equipment, and supplies are maintained in accordance with safety and regulatory standards.
4. Utilizes appropriate equipment, tools, and resources to promote a safe work environment.
5. Promptly reports any unsafe conditions, incidents, or potential hazards in accordance with established procedures.     

Privacy/Compliance:   

1. Maintains the confidentiality, privacy, and security of all patient, employee, and volunteer information, accessing such information only on a need-to-know basis for legitimate business purposes.
2. Complies with all applicable regulatory requirements related to corporate integrity, privacy, and data security, and promptly reports any suspected unethical, fraudulent, or unlawful activity in accordance with established protocols.
3. Demonstrates and upholds the highest standards of ethical conduct, professionalism, and integrity in all duties and interactions.

    Flexibility:

1. Available for all shifts and, when required, able to work evenings and weekends.

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 management’s assignment of essential functions; it does not proscribe 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.

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.