Patient Service Representative II - AHWFB Plastic Surgery

About the role

The Patient Services Representative III facilitates all components of patient registration by accurately and efficiently handling the day-to-day operations relating to a patient's scheduled appointment. This includes obtaining all necessary demographic and financial information to ensure that the most accurate patient data is obtained and populated into the patient record. This role is also responsible for creating a positive patient experience and representing Advocate Health Wake Forest Baptist and partner organizations in a professional manner.

Responsibilities

• Interview patients in-person and/or by phone to obtain all required information for hospital records and billing systems.
• Pre-register all scheduled patients for admission, partial hospitalization, and outpatient services according to department policies and procedures.
• Verify insurance coverage and obtain authorization for all services requiring pre-certification.
• Process internal and outgoing referrals, as needed, per department procedures.
• Perform clerical functions as needed, including answering phones, taking messages, chart processing, faxing and scanning.
• Collect and process upfront deposits or set-up payment arrangements, as required.
• Screen patients for Medicaid, Affordable Care Act or hospital sponsored financial program and provide appropriate documentation and referral.
• Assist other team members where necessary.
• Adhere to department policies and procedures related to verification of eligibility, benefits, pre-authorization requirements, available payment options, financial counseling and other identified financial clearance related duties.
• Complete assigned registration functions within multi-specialty clinic and/or emergency department, which may include claim edit work queues, pre-certifications and authorizations.
• Sequence multiple physician visits and complete registration activities within multiple registration platforms.
• Assist team with escalated issues, train other team members as needed and act as a subject matter expert.
• Participate in departmental performance improvement initiatives.
• Perform other duties as assigned or requested by Supervisor or Manager, such as acting as back up in other departments.
• Understand and maintain operations knowledge of Medicare and other state and federal government payor compliance requirements for the population served.

Qualifications

• High school diploma or equivalent and three years of experience working in a role within a customer service, fast paced environment with high volume of either calls or in-person requests; or an equivalent combination of education and experience.

Skills

• EPIC Cadence experience preferred.
• Expert knowledge of patient access services and the overall effect on the revenue cycle.
• Thorough understanding of commercial and government insurance plans, payer networks, government resources and medical terminology.
• Understand and maintain operations knowledge of Medicare and other state and federal government payor compliance requirements for the population served.
• Demonstrated proficiency in communicating effectively with a customer and simplifying complex information.
• Demonstrated ability of critical thinking skills and adhering to compliance protocols.
• Demonstrated ability to handle escalated issues, train/mentor other team members and viewed as a subject matter expert.
• Ability to navigate Internet Explorer and Microsoft Office Suite of applications.
• Experience working in a role that requires prioritization of multiple critical priorities while ensuring quality and achievement of performance metrics.
• Demonstrated ability to meet or exceed performance metrics.
• Ability to handle sensitive information and maintain HIPAA compliance.

Pay

$21.85 - $32.80 per hour

Schedule

Monday - Friday, 8am to 5pm

Benefits

• 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