Patient Service Representative - Greensboro Northwest Pediatrics

Advocate Health•Greensboro, NC

5d•$21 - $31

About The Position

The Patient Services Representative (PSR) completes patient registration duties, including collecting and validating accurate patient demographic and insurance information, obtaining pre-certification or authorization as required, and entering necessary information into the Wake Forest Baptist Medical Center ADT system. The PSR informs patients of estimated financial liability, collects patient payments, identifies patients who may need financial assistance, and refers them to financial counseling when appropriate. The role requires multitasking, effective problem solving, and fostering positive relationships with patients to provide quality service. The position is full time, 40 hours per week, with a Monday–Friday clinic schedule and alternating Saturdays. The work is performed in a normal office environment. The representative must be able to sit for most of the workday, occasionally lift up to 10 pounds, and operate the equipment necessary to perform the job.

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 articulate explanations and comply with updates to insurance pre-certification requirements.
Mathematical aptitude and 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.
Ability to sit for most of the workday and occasionally lift up to 10 pounds.

Nice To Haves

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

Responsibilities

Greet patients arriving for appointments and monitor patient flow to support efficient, courteous care.
Ensure patient demographic and insurance information is complete and accurate.
Register walk-in patients and verify or update demographic and insurance information as needed.
Verify insurance benefits and obtain, calculate, and collect patients’ out-of-pocket financial liability, including past-due and current balances or estimates.
Follow the Financial Clearance policy for non-urgent services when financial 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 additional patient responsibility when applicable, and providing appropriate documents.
Maintain and reference knowledge and 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 productivity requirements and department performance expectations, including a 98% accuracy rate and established productivity measurements.
Maintain positive working relationships with patients, families, and clinical staff and collaborate to support concise, timely information flow.