Patient Service Representative I PRN

Advocate Health•Concord, NC

1d•$21 - $31

About The Position

The Patient Service Representative I supports patient access and revenue cycle operations by providing welcoming, prompt service in accordance with the organization’s customer service philosophy and AIDET standards. The role explains the registration and care process, anticipated wait times, the purpose and safeguarding of patient information, and registration documents requiring signatures. It completes pre-registration and registration activities, manages related calls, and prepares required records and documents. The representative verifies insurance coverage and benefits, identifies patient financial responsibilities, and collects applicable copayments, coinsurance, and other out-of-pocket amounts. The role supports authorization and precertification for inpatient and outpatient services, communicates coverage limitations and financial risks, and coordinates with patients, Financial Counseling, physicians, Care Coordinators, Utilization Management, and department leaders to address eligibility, order, and coverage concerns. It also maintains knowledge of applicable insurance requirements and federal and state regulations. The position participates in team projects, departmental in-services, and other assignments that support the department’s mission. For registrars at offsite imaging centers, additional duties may include transcribing written physician orders through CPOE, light cleaning of changing areas, printing and distributing patient results CDs in accordance with HIPAA considerations, and escorting patients to changing areas. The role operates in a normal office environment and requires a flexible schedule based on departmental needs. The description notes that the stated duties are not exhaustive and that other related duties may be assigned.

Requirements

High school diploma.
Two years of experience in Patient Access or related experience in general physician office support, a billing office, an insurance office, hospitality, or a call center in any industry.
Intermediate math skills acquired through classroom work or work experience.
Typing speed of 25 words per minute.
Basic understanding of web-based systems and proficiency in data entry.
Ability to prioritize and organize workload.
Sophisticated interviewing, communication, and negotiation skills.
Ability to make independent decisions and work as a team member.
Ability to work variable hours based on organizational needs, including evenings, weekends, and holidays.
Ability to sit, stand, walk, lift, carry, squat, and bend frequently, and twist, rotate, and kneel occasionally throughout the workday.
Frequently lift up to 10 pounds and occasionally lift 20 pounds or more; push or pull up to 50 pounds with assistance.
Functional speech and hearing and fine motor skills for keyboard data entry.
Ability to use equipment necessary to perform the job.

Responsibilities

Greet and acknowledge patients and family members promptly and warmly; explain services, expected duration, the registration process, and the handling of patient information; and provide a clear handoff to the next area.
Verify insurance coverage and benefits for walk-in patients, identify out-of-pocket expenses, and collect applicable copayments, coinsurance, and other amounts in accordance with policy.
Use electronic systems to confirm eligibility and discuss findings with patients; follow department policies to address coverage eligibility and in-network status issues.
Screen uninsured patients for urgent status, follow charity procedures, refer patients for financial counseling when appropriate, and consult leaders about urgent versus non-urgent or elective care questions.
Screen walk-in orders for policy compliance and work with physicians, Care Coordinators, and clinical leaders to resolve order-quality or standards issues.
Obtain security authorization and precertification for inpatient and outpatient services and notify relevant parties when patients are uninsured or covered only by Third Party Liability or Workers Compensation.
Maintain knowledge of software used to verify eligibility and identify potential balances related to Medicare coverage limits and Medicaid eligibility rules; communicate risks to appropriate teams.
Notify patients when authorization has not been obtained, explain potential financial impacts and patient responsibility, and collect and analyze clinical data needed for prior authorization and precertification.
Stay current on insurance requirements and federal and state billing regulations; follow procedures for identifying and notifying Primary Care Physicians for HMO plans and communicate managed-care or commercial coverage limitations.
Accurately enter patient demographic and insurance information in the ADT system, including carrier codes, benefit and eligibility records, and authorization data.
Pre-register and register patients for ancillary and nursing units using established procedures; prepare required documents and records and provide education about documents requiring patient signatures.
Manage incoming and outgoing calls to complete pre-registrations and generate, assemble, and process registration documents.
Participate in departmental team-building activities, projects, required in-services, and special assignments.
At offsite imaging centers, accurately transcribe written physician orders through CPOE, seek clarification when needed, clean changing areas as needed, print and distribute exam-results CDs while observing HIPAA considerations, and escort patients to changing areas as needed.

Benefits

Paid Time Off programs.
Medical, dental, vision, life, and short- and long-term disability benefits.
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.
Career development programs.
Premium pay, including shift and on-call pay, where applicable.
Incentive pay for select positions.
Opportunity for annual increases based on performance.