Patient Service Representative I - AHWFB Surgical Specialists-Wilkes

About the role

The Patient Services Representative (PSR) is responsible for completing patient registration duties including but not limited to collecting and validating accurate patient demographic and insurance information, obtaining pre-certification or authorization as required, and entering all necessary information into Wake Forest Baptist Medical Center (WFBMC) ADT system. The PSR is responsible for informing the patient of their estimated liability, collecting patient liabilities, identifying patients in need of financial assistance and referring patients to financial counseling as necessary. This position requires multi-tasking and effective problem solving skills. It is expected that the PSR will foster positive relationships with all patients in an effort to provide quality service.

Responsibilities

• Greets patients arriving for their appointments.
• Maintains patient flow to ensure efficient and courteous service.
• Ensures all patient demographic and insurance information is complete and accurate.
• Completes the registration process on walk-in patients, verifies and / or updates patient information.
• Verifies insurance benefits, calculates and collects patient's out-of-pocket financial liability, and requests/pulls past due and present balances.
• Fulfills financial clearance requirements for non-urgent patient services.
• Identifies and refers patients in need of financial assistance to a Financial Counselor.
• Performs visit closure, including checking out patients, scheduling follow-up appointments, collecting additional patient responsibility (when applicable), and providing patient with appropriate documents.
• Maintains knowledge of and reference materials related to Medicare, Medicaid, and third-party payer requirements, guidelines, and policies.
• Communicates issues involving customer service and process improvement opportunities to management.
• Maintains a 98% accuracy rate and meets established department productivity measurements.
• Maintains excellent public relations with patients, families, and clinical staff.
• Communicates effectively with all internal and external customers.

Requirements

• High school diploma or GED required.
• Patient access (scheduling, registration and financial clearance), insurance verification, billing or certified medical assistant experience preferred.

Qualifications

• Licenses, Certifications, and Registrations: N/A
• Knowledge and ability to articulate explanations of Medicare, HIPAA, and EMTALA rules and regulations and comply with updates on insurance pre-certification requirements.
• Mathematical aptitude, effective oral and written communication skills, and critical thinking skills.
• Understanding of basic human anatomy, medical terminology and procedures for application in the patient referral, pre-certification and authorization processes.
• Ability to speak effectively to customers or employees of the organization; presents a pleasant, professional demeanor and image during telephone conversations.
• Ability to handle sensitive and confidential information according to internal policies.
• Experience with Microsoft Outlook, Word and Excel and ADT software.
• Ability to write routine correspondence, calculate figures and amounts such as discounts and percentages.
• Must be able to work with minimal supervision, to problem solve in a high profile and high stress area and interact positively with all internal and external customers while possessing the ability to determine priority of work.

Skills

• Ability to identify and understand issues and problems.
• Knowledge and ability to articulate explanations of Medicare, HIPAA, and EMTALA rules and regulations and comply with updates on insurance pre-certification requirements.
• Mathematical aptitude, effective oral and written communication skills and critical thinking skills.
• Understanding of basic human anatomy, medical terminology and procedures for application in the patient referral, pre-certification and authorization processes.
• Ability to speak effectively to customers or employees of the organization; presents a pleasant, professional demeanor and image during telephone conversation.
• Ability to handle sensitive and confidential information according to internal policies.
• Experience with Microsoft Outlook, Word and Excel and ADT software.
• Ability to write routine correspondence, calculate figures and amounts such as discounts and percentages.
• Must be able to work with minimal supervision, to problem solve in a high profile and high stress area and interact positively with all internal and external customers while possessing the ability to determine priority of work.

Benefits

Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including:

• Compensation
• Premium pay
• Incentive pay for select positions
• Opportunity for annual increases based on performance
• Benefits and More
• Paid Time Off programs
• Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
• Flexible Spending Accounts for eligible health care and dependent care expenses
• Family benefits such as adoption assistance and paid parental leave
• Defined contribution retirement plans with employer match and other financial wellness programs
• Educational Assistance Program

Work Environment

Exposed to a normal office environment. Must be able to sit the majority of the workday. Occasionally lifts up to 10 lbs. Operates all equipment necessary to perform the job.