Patient Service Representative I

Advocate Health • Rome, GA

2d • $20 - $30 • Onsite

About The Position

The Patient Service Representative I welcomes patients and helps ensure appointments proceed efficiently and courteously. The role includes registering patients, maintaining accurate demographic and insurance information, reviewing insurance benefits, and collecting patient financial responsibility. The representative follows financial-clearance procedures, refers patients who may need assistance to a Financial Counselor, and completes visit closure by checking out patients, scheduling follow-up appointments, collecting applicable balances, and providing documents.

The position requires knowledge of payer requirements and accepted insurance plans, effective communication with patients and colleagues, and the ability to meet established service, accuracy, and productivity expectations. The representative also identifies customer-service and process-improvement issues and communicates them to management. The work is performed in a normal office environment; the schedule is Monday through Friday, 8 a.m. to 5 p.m., for 40 hours per week.

Requirements

• High school diploma or GED.
• Ability to identify and understand issues and problems, examine data, and draw logical conclusions.
• Knowledge of Medicare, HIPAA, and EMTALA rules and regulations, and ability to comply with updates to insurance pre-certification requirements.
• Mathematical aptitude, effective oral and written communication, and critical-thinking skills.
• Understanding of basic human anatomy, medical terminology, and procedures used in patient referral, pre-certification, and authorization processes.
• Ability to communicate effectively with customers and employees and maintain a pleasant, professional demeanor during telephone conversations.
• 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, Excel, and ADT software.
• Ability to write routine correspondence and calculate figures and amounts such as discounts and percentages.
• Ability to work with minimal supervision, solve problems in a high-profile, high-stress area, interact positively with internal and external customers, and prioritize work.
• Meet established department productivity measurements and a 98% accuracy-rate expectation.

Nice To Haves

• Experience in patient access, including scheduling, registration, or financial clearance.
• Insurance verification experience.
• Billing experience.
• Certified medical assistant experience.

Responsibilities

• Greet patients arriving for appointments and monitor patient flow to support efficient, courteous service.
• Ensure patient demographic and insurance information is complete and accurate.
• Register walk-in patients and verify or update demographic and insurance information when needed.
• Review insurance benefits and obtain, calculate, and collect patients’ out-of-pocket financial liability.
• Request and collect past-due and current balances or estimates due.
• Follow the Financial Clearance policy for non-urgent services when clearance or authorization has not been completed, as appropriate.
• Identify patients in need of financial assistance and refer them to a Financial Counselor.
• Complete visit closure, including checking out patients, scheduling follow-up appointments, collecting applicable patient responsibility, and providing appropriate documents.
• Maintain knowledge and reference materials concerning Medicare, Medicaid, third-party payer requirements, insurance plans requiring pre-authorization or referral, and currently accepted insurance plans.
• Communicate customer-service issues and process-improvement opportunities to management.
• Meet department productivity requirements and performance expectations, including a 98% accuracy rate.
• Maintain positive relations with patients, families, and clinical staff and collaborate to support concise, timely information flow.
• Perform other related duties as required.

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.
• Competitive compensation, potential premium pay, incentive pay for select positions, and opportunity for annual performance-based increases.
• Career development and well-being programs.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED