Patient Service Representative I Hospital

Responsibilities

• Creates the initial electronic health record that serves as the foundation of the patient medical record used by all members of the healthcare team.
• Prevents creation of duplicate medical records that can cause treatment safety issues and billing problems.
• Ensures compliance with organizational accrediting bodies to use identifiers for positive patient identification prior to care delivery.
• 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 to ensure timely payment and prevent billing issues.
• Maintains confidentiality of patient personal, financial, and medical records in accordance with HIPAA.
• Understands insurance basics, including commercial and government plans, and Advocate Health’s contracted plans.
• Discusses financial information and obligations with patients and knows when to refer them to Financial Advocates.
• Ensures compliance with government regulations, including HIPAA, EMTALA, Consent for Treatment, Medicare notices (IMM, MOON), and Advanced Beneficiary Notice (ABN).
• Obtains required patient or guarantor signatures.
• May schedule patient appointments, coordinate cancellations, reschedules, waitlist requests, and recalls.
• Provides accurate information regarding test preparations, arrival times, medication guidelines, and facility directions.
• Creates a welcoming environment by demonstrating extraordinary customer service for patients and visitors.
• Greets patients, responds to routine requests, answers telephones, screens calls, and takes messages.
• Assists patients with transportation, directions, wheelchairs, interpreter services, and other needs.
• Monitors and works assigned electronic health record work queues following department-approved processes.
• Interacts with physicians and staff to resolve patient care issues.
• Collects and manages payments, including cash, while following security protocols.

Requirements

• High school diploma or equivalent required.
• Demonstrates Advocate Health’s purpose, values, and behaviors.
• Ability to work independently in a high-stress, fast-paced environment with frequent interruptions.
• Strong attention to detail, accuracy, and organizational skills.
• Excellent customer service, communication (written and verbal), and interpersonal skills.
• Service recovery skills and ability to handle sensitive and confidential information.
• Independent thinking, problem-solving, and ability to triage issues.
• Educates patients on insurance coverage, including services not covered by their health plan.
• Strong technical proficiency with insurance verification tools, EPIC electronic medical record, patient liability estimation tools, Microsoft Office, email, and phone systems.
• Understanding of basic medical and insurance terminology and abbreviations.
• Knowledge of HIPAA, Medicare, Medicaid, managed care, and commercial payers.
• Ability to articulate and comply with Medicare/HIPAA/EMTALA rules and insurance pre-certification requirements.
• Ability to act as a resource for other staff.

Skills

• Multitasking and prioritization in a fast-paced environment.
• Proficiency with computer systems and electronic health records.
• Cash handling and payment collection.
• Customer service and professional demeanor.
• Fine motor skills for keyboard data entry.

Physical Requirements and Working Conditions

• May require travel and exposure to weather and road conditions.
• Responds quickly to patient medical status and emergency situations in clerical areas.
• CPR certification may be required based on service location.
• Notary training/licensure may be required for certain service lines or facilities.
• Exposed to a normal office environment with significant patient and public contact.
• May be exposed to ill or contagious patients.
• Frequent transitions between sitting and standing; ability to stand and sit for extended periods.
• Frequently lifts up to 10 lbs. and occasionally lifts 20 lbs. or more.
• Ability to push/pull up to 50 lbs. with assistance (e.g., moving equipment or transporting patients).
• Escorts patients to nursing units or outpatient departments as needed.
• Sensory requirements include vision, hearing, touch, and clear speech.
• May be asked to work a flexible schedule to meet department needs.

Preferred Qualifications

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