Patient Service Representative I-PRN

About the role

PRN position providing approximately 24 hours per week, scheduled primarily during nights and weekends as needed.

Major Responsibilities

• Creates the initial electronic health record and prevents duplicate medical records to ensure treatment safety and accurate billing.
• Ensures compliance with organizational accrediting bodies by positively identifying patients prior to care delivery.
• Checks in and registers patients; obtains and verifies complete demographic, guarantor, and insurance information; collects co-pays and other patient financial responsibilities.
• Maintains confidentiality of patient personal, financial, and medical information in accordance with HIPAA.
• Recognizes commercial and government insurance plans; understands which plans Advocate Health contracts with and when a statement of financial responsibility is required.
• Discusses financial obligations with patients and refers to Financial Advocates as needed.
• Ensures compliance with HIPAA, EMTALA, Consent for Treatment, Patient Rights and Responsibilities, IMM, MOON, Notice of Privacy Practices, MSPQ, ABN, and other regulatory requirements.
• Obtains required patient or guarantor signatures.
• Schedules appointments; coordinates cancellations, reschedules, wait list requests, and recall requests.
• Provides patients with accurate information on test preparations, arrival times, medication/food/beverage guidelines, check-in procedures, and directions.
• Creates a welcoming environment by demonstrating exceptional customer service; greets patients and visitors, answers routine requests, screens and takes messages.
• Assists patients with transportation needs, directions, wheelchair access, interpreter services, and other support.
• Monitors and works assigned electronic health record work queues following department processes.

Licensure, Registration, And/or Certification Required

None

Education Required

High School Graduate.

Experience Required

None

Knowledge, Skills & Abilities Required

• Demonstrate Advocate Health purpose, values, and behaviors.
• Ability to work independently in high-pressure, fast-paced environments; set and meet deadlines; multitask and prioritize with frequent interruptions and no direct supervision.
• Strong attention to detail and accuracy.
• Excellent customer service and service recovery skills.
• Independent thinking and problem-solving; ability to exercise judgment to triage issues.
• Excellent written and verbal communication and interpersonal skills; ability to interact professionally with patients, visitors, staff, and physicians.
• Educate patients on insurance coverage aspects of their care and manage discussions regarding services not or potentially not covered by their health plan.
• Interact with physicians and staff to resolve patient care issues.
• Collect and manage payments including cash; follow security protocols for cash handling.
• Strong technical proficiency with insurance verification/eligibility tools, EPIC electronic medical record, patient liability estimation tools, email, Microsoft Office, internet browsers, and phone systems.
• Understanding of basic medical and insurance terminology and abbreviations used in scheduling and registration.
• HIPAA-compliant and knowledgeable of applicable state and federal rules and regulations.
• Ability to handle sensitive and confidential information according to internal policies.
• General understanding of health insurance including Medicare, Medicaid, managed care, and commercial payers.
• Ability to explain Medicare/HIPAA/EMTALA rules and regulations and comply with updates on insurance pre-certification requirements.
• Excellent organizational skills and ability to act as a resource to other staff.

Physical Requirements And Working Conditions

• May require travel; exposed to weather and road conditions.
• Responds 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 as appropriate for service line or facility.
• Operates all necessary equipment.
• 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; must be able to stand and sit for extended periods and be physically mobile throughout the workday.
• Lifting up to 10 lbs. frequently; occasionally lifts 20 lbs. or more.
• Must be able to push/pull up to 50 lbs. with assistance when moving equipment, supplies, or transporting patients.
• Escorts patients to nursing units or outpatient departments as needed.
• Sensory requirements include vision, hearing, touch, and clear speech.
• Fine motor skills required for keyboard data entry.
• May be asked to work a flexible schedule to meet department needs.

Preferred Job Requirements

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