Patient Service Representative I AHWFB

American Addiction Centers • Winston-Salem, NC

2d • Onsite

About The Position

This is a full-time position in the Department of Ambulatory Services, specifically within the WFBMG University Group Practice at WFBMC Main. The role involves greeting patients, managing patient flow, ensuring accurate demographic and insurance information, completing registrations, verifying insurance benefits, collecting patient financial liabilities, and assisting patients with financial clearance and assistance referrals. The position also requires performing visit closure tasks, maintaining knowledge of payer requirements, communicating customer service issues, and meeting productivity and accuracy standards.

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 on walk-in patients, verifying and/or updating patient demographic and insurance information.
• Verifies insurance benefits, calculates and collects the patient’s 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 obtained.
• 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 collaborate for concise and timely information flow.

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

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 1-10 employees