Patient Service Representative I Hospital

American Addiction Centers • Milwaukee, WI

5d • Onsite

About The Position

This role is responsible for creating the initial electronic health record, which is fundamental for the entire healthcare team. It also prevents the creation of duplicate records, ensuring patient safety and preventing billing issues. The position requires adherence to organizational mandates for positive patient identification to ensure safety. Responsibilities include checking in and registering patients, collecting and verifying demographic, guarantor, and insurance information, and collecting co-pays and other patient out-of-pocket expenses. Accurate registration information is crucial for timely payment and preventing billing problems and patient complaints. The role also involves maintaining strict confidentiality of patient information in accordance with HIPAA. The Patient Service Representative must understand insurance basics, recognize commercial and government plans, know which plans Advocate Health contracts with, and when a statement of financial responsibility is needed. They will discuss financial information and obligations with patients and know when to refer them to Financial Advocates. Additionally, they must be knowledgeable about government agency and regulation compliance, including 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 is also a key duty. The role may involve scheduling patient appointments, coordinating cancellations, reschedules, wait list requests, and recall requests. Providing accurate information about test preparations, arrival times, medication guidelines, check-in procedures, and directions is essential. Creating a welcoming and professional environment through exceptional customer service is paramount. This includes greeting patients and visitors, responding to requests, answering telephones, screening calls, and taking messages. Assistance may be offered for transportation needs, directions, wheelchair access, and interpreter services. The position requires monitoring and working 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.
• Demonstrated technical proficiency including experience with insurance verification/eligibility tools, EPIC electronic medical record, patient liability estimation tools, electronic email, Microsoft Office, internet browser and phone technology.
• 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.

Nice To Haves

• 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 that is utilized by all members of the healthcare team.
• Prevents creation of duplicate medical records that can cause treatment safety issues and billing problems.
• Follows and 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 to ensure patient safety.
• 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 the Health Insurance Portability and Accountability Act (HIPAA).
• Knows 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.
• Has knowledge of which rules, forms and questions must be enforced to make sure Advocate Health remains compliant with government agencies and regulations. Examples are HIPAA, Emergency Medical Treatment and Active Labor Act (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), Advanced Beneficiary Notice (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 our 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

• Paid Time Off programs
• medical, dental, vision, life, and Short- and Long-Term Disability
• 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

What This Job Offers

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