Patient Service Representative (PSR) - Orthopedic Surgery

American Addiction Centers•West Allis, WI

2d•$20 - $30•Onsite

About The Position

The Patient Service Representative (PSR) 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. This role is crucial for preventing duplicate medical records, ensuring treatment safety, and avoiding billing problems. The PSR must positively identify patients using organizational identifiers to ensure patient safety, in compliance with accrediting bodies. They will check in and register patients, verifying demographic, guarantor, and insurance information, and collecting co-pays. Accurate registration information is vital for timely payment and preventing billing issues. Maintaining patient confidentiality in accordance with HIPAA is paramount. The PSR needs a solid understanding of insurance basics, including commercial and government plans, and knowledge of AAH's contracted plans. They must be able to discuss financial obligations with patients and refer them to Financial Advocates when necessary. The role also requires knowledge of compliance regulations such as HIPAA, EMTALA, Consent for Treatment, Patient Rights and Responsibilities, and various Medicare notices, obtaining necessary signatures. Additionally, the PSR may schedule appointments (including virtual and procedural), coordinate cancellations and reschedules, and provide patients with detailed information about test preparations, arrival times, and check-in procedures. They may also handle visit closure, provide after-visit summaries, and assist patients with the patient portal/app. Creating a welcoming environment through exceptional customer service is key, including greeting patients, answering phones, and maintaining positive public relations. The PSR will proactively communicate customer service and process improvement opportunities to management and offer assistance with transportation, directions, wheelchairs, and interpreter services. Responsibilities may also include e-scanning documents, managing faxes, handling in-basket messages, and following clinical team directions for emergent needs. Monitoring and working assigned electronic health record work queues according to department processes is also a core function. The role may involve assisting department leadership with orientation and training.

Requirements

High School Diploma or GED.
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 manage high-volume workloads with many interruptions in a fast-paced environment without direct supervision.
May be cross-trained across various specialties and provide staffing support as needed.
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 the patient care.
Collect and manage payments including cash payments, if applicable, and follow security related to cash handling.
Strong understanding and comfort level with computer systems and proficient typing skills.
Demonstrated technical proficiency including experience with electronic email, Microsoft Office, internet browser and phone technology.
Ability to handle sensitive and confidential information according to internal policies.
Excellent organizational skills.
Demonstrated ability to effectively act as a resource to other teammates.

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 AAH 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 AAH 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, including virtual and procedural; may also coordinate cancellations, reschedules, wait list requests, and recall requests.
May provide accurate, detailed information regarding test preparations, patient arrival time, medication/food/beverage consumption guidelines, check-in procedures, directions to facility, etc.
May perform visit closure, including checking out patients after their visit, scheduling follow-up appointment(s), and providing patients with the after-visit summary.
May educate and support patients with the patient portal/app.
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.
Maintains excellent public relations with patients, families, and clinical staff as well as demonstrates a willingness and ability to work collaboratively with others for concise and timely flow of information.
Proactively communicates issues involving customer service and process improvement opportunities to management.
Offers various assistance to patients to include: arranging transportation needs, providing directions, locating a wheelchair, coordinating interpreter services, etc.
May be responsible for e-scanning documents to Health Information Management (HIM), addressing incoming/outgoing fax, addressing inbasket messages via the electronic health record, and following direction from the clinical team for emergent needs.
Monitors and works assigned electronic health record work queues, following the department’s approved process.
May assist department leadership with orientation and training.