Patient Services Representative II

Full-time, benefits-eligible position within Ambulatory Services at WFBMC Main - Administration.

Schedule

• 40 hours per week
• 8:00 am – 5:00 pm

Pay

$21.85 – $32.80 per hour

Requirements

• High school diploma or equivalent
• Three years of experience in a customer-service role within a fast-paced, high-volume call or in-person environment, or an equivalent combination of education and experience

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 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 programs and provide appropriate documentation and referral
• Assist other team members as 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 duties
• Complete assigned registration functions within multi-specialty clinic and/or emergency department, including 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 serve 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 backup in other departments
• Understand and maintain operational knowledge of Medicare and other state and federal government-payer compliance requirements for the population served

Skills & Qualifications

• 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
• Demonstrated proficiency in communicating effectively with customers and simplifying complex information
• Demonstrated ability in critical thinking and adhering to compliance protocols
• Demonstrated ability to handle escalated issues, train/mentor other team members, and serve as a subject-matter expert
• Ability to navigate Internet Explorer and the 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

Work Environment

• Clean, indoor environment
• Minimal travel to clinic locations where assistance is needed

Physical Requirements

• Sitting: 65% of the time
• Standing: 0% of the time
• Walking: 35% of the time
• Bending: 0% of the time
• Reaching with arms: 0% of the time
• Finger and hand dexterity: required
• Talking: required
• Hearing: required
• Seeing: required
• Lifting, carrying, pushing, and/or pulling up to 20 lbs. maximum

Benefits

• Paid Time Off programs
• Health and welfare benefits (medical, dental, vision, life, 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
• Base compensation within the listed pay range based on qualifications, skills, relevant experience, and/or training
• Premium pay such as shift, on-call, and more based on the teammate’s job
• Incentive pay for select positions
• Opportunity for annual increases based on performance

About the Organization

Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia, and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience, and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health serves nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics, and rehabilitation, as well as organ transplants, burn treatments, and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.