Patient Service Representative I FT

Advocate Health•Cartersville, GA

1d•$20 - $30•Onsite

About The Position

The Patient Service Representative I greets patients arriving for appointments and monitors patient flow to support efficient, courteous care. The role ensures patient demographic and insurance information is complete and accurate, registers walk-in patients, and verifies or updates information when needed. It also involves reviewing insurance benefits, determining and collecting patients’ out-of-pocket costs and balances, and following financial clearance procedures for non-urgent services when clearance or authorization is incomplete. Patients needing financial assistance are referred to a Financial Counselor. The representative closes visits by checking out patients, scheduling follow-up appointments, collecting additional patient responsibility when applicable, and providing appropriate documents. The role maintains current reference materials and knowledge regarding Medicare, Medicaid, third-party payer requirements, insurance plans requiring preauthorization or referral, and accepted insurance plans. It communicates service issues and process-improvement opportunities to management and meets department productivity and accuracy expectations. The representative maintains positive relations with patients, families, and clinical staff and works collaboratively to support timely information flow. The position is based in a normal office environment and requires sitting for most of the workday, occasional lifting of up to 10 pounds, and operating equipment necessary to perform the job. Other related duties may be assigned.

Requirements

High school diploma or GED required.
Ability to identify and understand issues and problems, examine data, and draw logical conclusions based on available information.
Knowledge of Medicare, HIPAA, and EMTALA rules and regulations, and ability to articulate explanations and comply with updates to insurance precertification requirements.
Mathematical aptitude, effective oral and written communication skills, and critical-thinking skills.
Understanding of basic human anatomy, medical terminology, and procedures related to patient referral, precertification, and authorization processes.
Ability to speak effectively with customers or 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 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 determine work priorities.
Ability to sit for most of the workday and occasionally lift up to 10 pounds.

Nice To Haves

Experience in patient access (scheduling, registration, and financial clearance), insurance verification, billing, or as a certified medical assistant.

Responsibilities

Greet patients arriving for appointments and monitor patient flow to ensure 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 changes or additions have occurred.
Review insurance benefits and obtain, calculate, and collect patients’ out-of-pocket financial liability, past-due balances, current balances, or estimates due.
Follow the Financial Clearance policy for non-urgent services when financial clearance or authorization has not been completed, when appropriate.
Refer patients in need of financial assistance to a Financial Counselor.
Complete visit closure, including checking out patients, scheduling follow-up appointments, collecting additional patient responsibility when applicable, and providing appropriate documents.
Maintain knowledge of Medicare, Medicaid, and third-party payer requirements, guidelines, and policies; insurance plans requiring preauthorization or referral; and currently accepted insurance plans.
Proactively communicate customer service issues and process-improvement opportunities to management.
Meet productivity requirements and department performance expectations, including a 98% accuracy rate and established productivity measurements.
Maintain positive public relations with patients, families, and clinical staff, and collaborate to support concise and timely information flow.