Patient Service Representative I Hospital

Advocate Health•Concord, NC

1d•$21 - $31•Onsite

About The Position

This full-time position is responsible for creating the initial electronic health record, which serves as the foundation for the patient medical record used by the entire healthcare team. The role is crucial in preventing duplicate medical records that can lead to safety and billing issues. It also ensures patient safety by adhering to organizational mandates for positive patient identification before care delivery. The Patient Service Representative checks in and registers patients, verifies demographic and insurance information, and collects co-pays. Accurate registration information is vital for timely payment and preventing billing problems. The role requires maintaining strict confidentiality of patient information in accordance with HIPAA. Additionally, the position involves understanding insurance basics, recognizing different plan types, knowing Advocate Health's contracted plans, and determining when a statement of financial responsibility is needed. The representative must be able to discuss financial information with patients and refer them to Financial Advocates when necessary. They also ensure compliance with government regulations 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), obtaining necessary signatures. The role may also include scheduling appointments, coordinating cancellations, reschedules, and managing waitlists. Providing accurate information about test preparations, arrival times, dietary guidelines, check-in procedures, and directions is also a key responsibility. The position emphasizes creating a welcoming and professional environment through exceptional customer service, greeting patients, responding to requests, answering phones, screening calls, and taking messages. Assistance may be offered for transportation needs, directions, wheelchairs, and 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.
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.
High School Graduate.
None

Nice To Haves

CPR certification may be required based on service location.
Notary training/licensure may be required as appropriate for service line and/or facility.
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.
Prevents the creation of duplicate medical records.
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.
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 HIPAA.
Understands 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.
Ensures Advocate Health remains compliant with government agencies and regulations (e.g., HIPAA, EMTALA, Consent for Treatment, Patient Rights and Responsibilities, IMM, MOON, Notice of Privacy Practices, MSPQ, 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 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

Comprehensive suite of Total Rewards: benefits and well-being programs
Competitive compensation
Generous retirement offerings
Programs that invest in your career development
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