Patient Service Representative Gastroenterology

Advocate Health and Hospitals Corporation•Lexington, NC

3d•Onsite

About The Position

The Patient Service Representative for Gastroenterology is responsible for greeting patients, managing patient flow, and ensuring efficient and courteous service. This role involves completing the registration process, verifying and updating patient demographic and insurance information, and collecting patient financial liabilities. The representative will also obtain and calculate patient out-of-pocket expenses, request and collect past due and present balances, and follow financial clearance policies when necessary. Additionally, they will identify patients needing financial assistance and refer them to a Financial Counselor, perform visit closure tasks such as scheduling follow-up appointments and collecting payments, and maintain knowledge of payer requirements and policies. The role also includes proactively communicating customer service issues and process improvement opportunities to management, meeting productivity and accuracy requirements, and maintaining excellent public relations with patients, families, and staff.

Requirements

High school diploma or GED required.
Ability to identify and understand issues and problems.
Examines data and draws logical conclusions based on information available.
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.
Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals.
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.

Nice To Haves

Patient access (scheduling, registration and financial clearance), insurance verification, billing or certified medical assistant experience preferred.

Responsibilities

Greets patients arriving for their appointments and monitors patient flow to ensure efficient and courteous care.
Ensures all patient demographic and insurance information is complete and accurate.
Completes the registration process for walk-in patients, verifying and updating demographic and insurance information.
Verifies insurance benefits, calculates and collects patient out-of-pocket financial liability, and requests/collects past due and present balances.
Follows the Financial Clearance policy for non-urgent patient services if financial clearance or authorization has not been completed.
Identifies patients in need of financial assistance and refers them to a Financial Counselor.
Performs visit closure, including checking out patients, scheduling follow-up appointments, collecting additional patient responsibility, and providing necessary documents.
Maintains knowledge of Medicare, Medicaid, third-party payer requirements, guidelines, policies, insurance plans requiring pre-authorization/referral, and accepted insurance plans.
Proactively communicates customer service issues and process improvement opportunities to management.
Meets productivity requirements to ensure excellent customer service.
Meets or exceeds performance expectations of 98% accuracy rate and established department productivity measurements.
Maintains excellent public relations with patients, families, and clinical staff, and demonstrates a willingness to work collaboratively.