Patient Service Representative I

American Addiction Centers•Bermuda Run, NC

1d•Onsite

About The Position

This role is for a Patient Service Representative I within the 13346 Enterprise Revenue Cycle - Wake Forest Davie NC department. It is a PRN (part-time, as needed) position primarily for last-minute coverage in the Emergency Department (ED), requiring every other weekend shifts and some weekday shifts. The representative will undergo 3 weeks of training. The role involves greeting patients, ensuring all patient demographic and insurance information is complete and accurate, completing the registration process for walk-in patients, verifying insurance benefits, obtaining and collecting patient out-of-pocket financial liabilities, and performing visit closure. The representative must also maintain knowledge of various payer requirements and policies, proactively communicate issues, meet productivity and accuracy requirements, and maintain excellent public relations. Advocate Health is the third-largest nonprofit, integrated health system in the United States, formed from the combination of Advocate Aurora Health and Atrium Health. It services nearly 6 million patients, employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and is a national leader in clinical innovation, health outcomes, consumer experience, and value-based care. The company is committed to providing equitable care for all and provides more than $6 billion in annual community benefits.

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. Monitors patient flow to ensure patients are cared for in the most efficient and courteous manner.
Ensures all patient demographic and insurance information is complete and accurate.
Completes the registration process on walk-in patients, verifies and / or updates patient demographic and insurance information if changes or additions have occurred.
Verifies insurance benefits. Obtains, calculates and collects the patient's out of pocket financial liability. Requests and collects past due and present balances or estimates due.
Follows the Financial Clearance policy for non-urgent patient services if financial clearance has not been completed or authorization has not been obtained, when appropriate.
Identifies patients in need of financial assistance and refers patients to Financial Counselor.
Performs visit closure, including but not limited to checking out patients, scheduling follow-up appointment(s), collecting additional patient responsibility (when applicable) and providing patient with appropriate documents.
Maintains knowledge of and reference materials of the following: Medicare, Medicaid and third-party payer requirements, guidelines and policies, insurance plans requiring pre-authorization/referral and a list of current accepted insurance plans.
Proactively communicates issues involving customer service and process improvement opportunities to management.
Meets productivity requirements to ensure excellent service is provided to customers.
Meets or exceeds performance expectations of 98% accuracy rate and established department productivity measurements.
Maintains excellent public relations with patients, families, and clinical staff as well as demonstrates a willingness and ability to work collaboratively with others for concise and timely flow of information.

Benefits

Compensation Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training
Premium pay such as shift, on call, and more based on a teammate's job
Incentive pay for select positions
Opportunity for annual increases based on performance
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