Patient Service Representative

About the role

A Patient Service Representative (PSR) is often a patient’s first impression of Advocate Health and frequently is the starting point and foundation for all Revenue Cycle functions. The PSR helps prevent the loss of revenue and impacts operating margins through the accuracy and timeliness of their workflows. The PSR ensures mandated regulations are followed and patient satisfaction is optimized. The PSR plays a crucial role in connecting a variety of departments for the overall success of the patient’s experience and the organization’s financial success. Often works without direct supervision present.

Responsibilities

• Creates the initial electronic health record that serves as the foundation of the patient medical record utilized by all members of the healthcare team.
• Prevents creation of duplicate medical records that can cause treatment safety issues and billing problems.
• Follows and ensures compliance with the mandate of the organization’s accrediting bodies to use identifiers to positively identify a patient prior to the delivery of patient care to ensure patient safety.
• Checks in and registers patients; obtains and verifies complete demographic, guarantor, and insurance information; discusses and collects co-pays and other out-of-pocket patient responsibilities.
• Maintains complete confidentiality regarding patient personal/financial information and medical records in accordance with HIPAA.
• Understands insurance basics and recognizes commercial and government plans; knows which plans Advocate Health contracts with and when a statement of financial responsibility is needed.
• Discusses financial information and obligations with patients; knows how and when to refer patients to Financial Advocates.
• Understands and enforces rules, forms, and questions required for compliance with government agencies and regulations (e.g., HIPAA, EMTALA, Consent for Treatment, Patient Rights and Responsibilities, IMM, MOON, Notice of Privacy Practices, MSPQ, ABN).
• Obtains patient or guarantor signatures as required.
• May schedule patient appointments, coordinate cancellations, reschedules, wait list requests, and recall requests.
• Provides accurate, detailed information regarding test preparations, patient arrival time, medication/food/beverage consumption guidelines, check-in procedures, and directions to facility.
• Creates a welcoming and professional environment for patients and visitors by demonstrating extraordinary customer service.
• Greets patients and visitors; responds to routine requests for information; answers telephone, screens calls, and takes messages.
• Assists patients with transportation needs, directions, locating wheelchairs, coordinating interpreter services, etc.
• Monitors and works assigned electronic health record work queues, following the department’s approved process.
• Interacts with physicians and their staff to resolve issues related to patient care.
• Collects and manages payments, including cash payments, and follows security protocols related to cash handling.

Requirements

• High School Graduate (required).
• Demonstrated ability to work in a high-profile, high-stress area, working independently to set and meet deadlines, multitask, and prioritize work.
• Ability to handle large workloads with many interruptions in a fast-paced environment without direct supervision.
• Strong attention to detail and accuracy.
• Excellent customer service and interpersonal skills in a variety of situations, including service recovery.
• Demonstrated independent thinking, problem-solving skills, and ability to exercise judgment to triage issues and concerns.
• Excellent communication (written and verbal) skills; ability to effectively communicate with patients, visitors, staff, and physicians in a pleasant, professional demeanor.
• Ability to educate patients on insurance coverage aspects of their care, including managing discussions for services that may not be paid by their health plan.
• Strong understanding and comfort level with computer systems, including experience with insurance verification/eligibility tools, EPIC electronic medical record, patient liability estimation tools, electronic email, Microsoft Office, internet browsers, and phone technology.
• Understanding of basic medical and insurance terms and abbreviations typically used in patient scheduling and registration.
• HIPAA-compliant and knowledgeable of applicable state and federal rules/regulations.
• Ability to handle sensitive and confidential information according to internal policies.
• General understanding of health insurance: Medicare, Medicaid, managed care, and commercial payers.
• Knowledge and ability to articulate explanations of Medicare/HIPAA/EMTALA rules and regulations; compliance with updates on insurance pre-certification requirements.
• Excellent organizational skills; demonstrated ability to act as a resource to other staff.

Physical Requirements and Working Conditions

• This position may require travel and exposure to weather and road conditions.
• Responds quickly to patient medical status and emergency situations occurring in clerical areas.
• CPR certification may be required based on service location.
• Notary training/licensure may be required as appropriate for service line and/or facility.
• Operates all equipment necessary to perform the job.
• Exposed to a normal office environment with significant patient and public contact; may be exposed to ill or contagious patients.
• Must be able to transition from sitting to standing frequently and stand/sit for extended periods.
• Frequently lifts up to 10 lbs. and occasionally lifts 20 lbs. or more.
• Must be able to push/pull up to 50 lbs. with assistance (e.g., moving equipment, supplies, or transporting patients).
• Escorts patients to nursing units or outpatient departments as necessary.
• Sensory requirements include vision, hearing, and touch; must also be able to speak clearly.
• Must be able to use hands with fine motor skills for keyboard data entry.
• May be asked to work a flexible schedule to meet the needs of the department.

Preferred Qualifications

• Experience with insurance verification/eligibility tools, EPIC electronic medical record, patient liability estimation tools, electronic email, Microsoft Office, internet, and phone technology.