Patient Service Representative I Hospital

American Addiction Centers • Milwaukee, WI

2d • $21 - $31 • Onsite

About The Position

This role is responsible for creating the initial electronic health record, which is fundamental for all healthcare team members. A key aspect of this position is preventing duplicate medical records to ensure patient safety and avoid billing complications. The Patient Service Representative must positively identify patients using organizational mandates and accrediting body requirements prior to care delivery. They will check in and register patients, collecting and verifying comprehensive demographic, guarantor, and insurance information, and will discuss and collect co-pays and other patient out-of-pocket expenses. Accurate registration information is crucial for timely payments and preventing billing issues and patient complaints. The role also requires maintaining strict confidentiality of patient information in accordance with HIPAA. The representative needs a solid understanding of insurance basics, including recognizing commercial and government plans, knowing Advocate Health's contracted plans, and identifying when a statement of financial responsibility is necessary. They must be able to discuss financial obligations with patients and know when to refer them to Financial Advocates. Additionally, the position requires knowledge of and adherence to government agency regulations and compliance requirements, such as HIPAA, EMTALA, Consent for Treatment, Patient Rights and Responsibilities, Important Message from Medicare (IMM), Medicare Outpatient Observation Notice (MOON), Notice of Privacy Practices, Medicare Secondary Payer Questionnaire (MSPQ), and Advanced Beneficiary Notice (ABN). Signatures from patients or guarantors will be obtained as needed. The role may involve scheduling patient appointments, coordinating cancellations, reschedules, wait list requests, and recall requests. Providing clear and detailed information to patients regarding test preparations, arrival times, medication/food/beverage guidelines, check-in procedures, and directions is also a responsibility. The Patient Service Representative is expected to create a welcoming and professional environment through exceptional customer service, greeting patients and visitors, responding to inquiries, answering and screening telephone calls, and taking messages. Assistance may be offered to patients, including arranging transportation, providing directions, locating wheelchairs, and coordinating interpreter services. The representative will monitor and work assigned electronic health record work queues according to departmental processes.

Requirements

• Demonstrate the Advocate Health purpose, values and behaviors.
• Ability to work in a high profile and high stress area, working independently to set and meet deadlines, multitask and prioritize work.
• Must be able to handle large workloads with many interruptions in a fast-paced environment without direct supervision.
• Strong attention to detail and accuracy.
• Excellent customer service skills in a variety of situations.
• Must have excellent service recovery skills.
• Demonstrated independent thinking and problem-solving skills, ability to exercise judgment to triage issues and concerns.
• Excellent communication (written & verbal), customer service and interpersonal skills, ability to effectively communicate with a variety of patients, visitors, staff and physicians in a pleasant professional demeanor.
• Educate patients on the insurance coverage aspect of their care including managing the discussion for services that will not or may not be paid by their health plan.
• Interact with physicians and their staff to resolve issues related to patient care.
• Collect and manage payments including cash payments and follow security related to cash handling.
• Strong understanding and comfort level with computer systems.
• Demonstrated technical proficiency including experience with insurance verification/eligibility tools, EPIC electronic medical record, patient liability estimation tools, electronic email, Microsoft Office, internet browser and phone technology.
• Understanding of basic medical and insurance terms and abbreviations typically used in the patient scheduling and registration process.
• HIPAA-compliant and knowledgeable of applicable state and federal rules/regulations.
• Ability to handle sensitive and confidential information according to internal policies.
• General understanding of health insurance: Medicare, Medicaid, managed care, and commercial payers.
• Knowledge and ability to articulate explanations of Medicare/HIPAA/EMTALA rules and regulations and comply with updates on insurance pre-certification requirements.
• Excellent organizational skills.
• Demonstrated ability to effectively act as a resource to other staff.

Nice To Haves

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

Responsibilities

• Creates the initial electronic health record that serves as the foundation of the patient medical record that is utilized by all members of the healthcare team.
• Prevents creation of duplicate medical records that can cause treatment safety issues and billing problems.
• Follows and ensures compliance with the mandate of the organization’s accrediting bodies to use identifiers to positively identify a patient prior to the delivery of patient care to ensure patient safety.
• Checks in and registers patients; obtains and verifies complete demographic, guarantor, and insurance information; discusses and collects co-pays and other out-of-pocket patient responsibilities.
• Maintains complete confidentiality regarding patient personal/financial information and medical records in accordance with the Health Insurance Portability and Accountability Act (HIPAA).
• Knows insurance basics and recognizes commercial and government plans. Understands which plans Advocate Health contracts with and when a statement of financial responsibility is needed.
• Understands and discusses financial information and obligations with patients.
• Knows how and when to refer patients to Financial Advocates.
• Has knowledge of which rules, forms and questions must be enforced to make sure Advocate Health remains compliant with government agencies and regulations. Examples are HIPAA, Emergency Medical Treatment and Active Labor Act (EMTALA), Consent for Treatment, Patient Rights and Responsibilities, Important Message from Medicare (IMM), Medicare Outpatient Observation Notice (MOON), Notice of Privacy Practices, Medicare Secondary Payer Questionnaire (MSPQ), Advanced Beneficiary Notice (ABN).
• Obtains patient or guarantor signatures as required.
• May schedule patient appointments: may also coordinate cancellations, reschedules, wait list requests, and recall requests.
• Provides accurate, detailed information regarding test preparations, patient arrival time, medication/food/beverage consumption guidelines, check-in procedures, directions to facility, etc.
• Creates a welcoming and professional environment for our patients and visitors by demonstrating extraordinary customer service.
• Greets patients and visitors and responds to routine requests for information.
• Answers telephone, screens calls, and takes messages.
• Offers various assistance to patients to include arranging transportation needs, providing directions, locating a wheelchair, coordinating interpreter services, etc.
• Monitors and works assigned electronic health record work queues, following the department’s approved process.

Benefits

• Paid Time Off programs
• medical, dental, vision, life, and Short- and Long-Term Disability
• Flexible Spending Accounts for eligible health care and dependent care expenses
• 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: Part-time
• Career Level: Entry Level
• Education Level: High school or GED