Job Title: Medical & Dental Patient Service Representative

Status / Time: Full-Time
Reports to: Patient Services & Dental Revenue Manager
Position Type: Permanent
FLSA Classification: Hourly, Non-Exempt
Starting Pay Range: $16 ~ $22 / hour depending on experience

Position Summary:
The Medical & Dental Patient Service Representative (PSR) serves as the first point of contact for patients accessing medical and dental services and is an ambassador of ALOHA at Ko‘olauloa Health Center (KHC). This position performs a variety of patient access scheduling, registration, customer service, insurance verification, and administrative support functions to ensure efficient patient flow and exceptional patient experiences.

In addition to traditional PSR responsibilities, this role provides specialized support for dental services by preparing treatment cost estimates, verifying dental benefits, educating patients regarding their financial responsibility, and coordinating with dental providers and insurance carriers to facilitate patient care.

The PSR promotes timely access to services while supporting KHC’s mission, patient-centered medical home care model, and compliance with all applicable federal, state, regulatory, payer, and organizational requirements.

Key Responsibilities
Medical Patient Services

Patient Reception & Registration

• Greet and assist patients, visitors, and community members professionally and courteously.

• Register new patients and update demographic information for established patients.

• Verify patient identity and insurance eligibility.

• Obtain required registration documentation and signatures.

• Ensure accurate collection of patient demographics, contact, insurance, and guarantor information.

• Collect and document sliding fee program information when applicable.

• Process patient check-in and check-out activities.

• Maintain confidentiality in accordance with HIPAA requirements.

Scheduling

• Schedule medical appointments according to provider templates and organizational protocols, including patient recall and follow-up appointments.

• Contact patients about appointment reminders, cancellations, and rescheduling.

• Assist with patient waitlists and access management.

Customer Service

• Answer incoming telephone calls and electronic inquiries.

• Respond to general patient questions.

• Direct calls appropriately.

• Resolve routine patient concerns and escalate complex issues when necessary.

• Always maintain excellent customer service standards exemplifying the spirit of ALOHA.

Insurance Verification

• Verify medical insurance eligibility and benefits.

• Document insurance coverage accurately within the electronic health record (EHR).

• Identify coverage limitations and communicate relevant information to patients and staff.

• Support billing and Patient Services teams in obtaining required insurance information.

Dental Patient Services

Dental Scheduling & Registration

• Schedule dental appointments according to provider availability and treatment needs.

• Coordinate specialty referrals and follow-up appointments.

• Verify dental insurance benefits before appointments.

• Maintain accurate patient records within the dental management system and EHR.

Dental Insurance Verification

• Verify patient eligibility and dental benefits.

• Review covered services, annual maximums, frequency limitations, deductible requirements, waiting periods, and exclusions.

• Confirm network participation status.

• Document insurance coverage details accurately within the patient record.

Financial Counseling

• Educate patients regarding:

  • Benefits coverage

  • Deductibles

  • Coinsurance

  • Copayments

  • Annual maximum

  • Out-of-pocket responsibilities

• Explain payment policies and financial assistance options.

• Assist patients with payment planning in alignment with KHC’s policies.

Administrative Responsibilities

• Maintain accurate and complete documentation.

• Scan, upload, and index patient documents.

• Maintain reports, logs, and tracking tools as assigned.

• Participate in quality improvement initiatives.

• Support audits, compliance reviews, and site visits.

• Attend required meetings and trainings.

Compliance Responsibilities

• Comply with all HIPAA privacy and security requirements.

• Follow HRSA, FQHC, Medicare, Medicaid, and payer requirements.

• Adhere to KHC’s policies and procedures.

• Maintain confidentiality or patient, employee, and organizational information.

• Complete required compliance and safety training.

Minimum Qualifications

Education

• High school diploma or GED required.

Experience

• Federally Qualified Health Center (FQHC) experience is required.

• Minimum of one (1) year of customer service, medical office, dental office or healthcare registration experience required.

• Experience with insurance verification required.

• Experience with dental insurance, treatment estimates, and prior authorizations preferred.

• Experience using Dentrix Enterprise and AthenaOne.

Knowledge, Skills, and Abilities

Knowledge of:

• FQHC medical office workflows

• FQHC dental office workflows

• Dental insurance terminology

• Health insurance verification processes

• HIPAA regulations

• Customer service principles

• Electronic Health Records (EHR)

Ability to:

• Calculate treatment estimates accurately.

• Understand dental benefit structures.

• Interpret insurance eligibility information.

• Prepare and track prior authorization requests.

• Communicate complex insurance information in patient-friendly language.

• Work effectively in a fast-paced environment.

• Handle multiple priorities simultaneously.

• Maintain professionalism and confidentiality.

• Use computers, practice management software, and Microsoft Office applications.

Physical Requirements

• Frequent sitting, standing, and walking.

• Frequent use of computers and telephones.

• Ability to occasionally lift to 20 pounds.

• Ability to communicate clearly in person and by telephone.

Position Type and Expected Hours

• This job operates in a professional office environment with extensive employee and public contact and frequent interruptions. This role routinely uses standard office equipment.

• This is a full-time, forty (40) hours per week position. The usual workdays are Monday through Friday, 8:00 AM to 6:00 PM.

• Evening and weekend hours may be necessary to support operational needs, including community outreach and engagement activities.

• Some local travel to other sites or training sessions may be required.

• Onsite at one of KHC’s locations.

Clearance

• Proof of immunization or serology required for:

  • Tuberculosis

  • Hepatitis B

  • Influenza

  • Measles, Mumps, and Rubella (MMR)

  • Varicella

  • Tetanus, Diphtheria, and Pertussis

Confidentiality

As an employee of Ko’olauloa Health Center, you are bound by principles of medical ethics. You have both a legal and moral obligation to protect the privacy of our patients. In the course of your work, you will have access to confidential information regarding patients and/or the practice’s confidential business. You must refrain from discussing any personal information about a patient, a patient’s condition, a patient’s finances, proprietary company information, personnel salaries, and/or the practice's confidential business with any third person. This includes, but is not limited to, other employees, your spouse, family, or friends. Confidentiality is so important that any breach of this policy will be considered grounds for termination. Review and signature of the Agreement is a condition of employment.

ADA Statement
The Americans with Disabilities Act prohibits discrimination and ensures equal opportunity for persons with disabilities in employment, state and local government services, public accommodations, commercial facilities, and transportation. It also mandates the establishment of TDD/telephone relay services.

EEO Statement
Ko’olauloa Health Center believes that all applicants and employees are entitled to equal employment opportunities and maintains a policy of non-discrimination with respect to religion, color, sex, sexual orientation, national origin, age, veteran status, marital status, physical or mental disability, or any other legally protected class in accordance with applicable law, except where a bona fide occupational qualification exists. Ko’olauloa Health Center will comply with all phases of employment including, but not limited to, hiring practices, transfers, promotions, benefits, discipline, and discharge.

General Employment Statement
The above statements are intended to describe the general nature and level of work being performed by employees assigned to this position. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel as qualified. A person in this role may need to perform other duties as assigned related to departmental support and needs.

Ko‘olauloa Health Center is a drug-free and alcohol-free workplace.