Patient Service Representative (PSR) - Pediatrics and Adult Specialty Clinic

Advocate Health • Greenfield, WI

3d • $20 - $30 • Onsite

About The Position

The Patient Service Representative (PSR) supports patient access and front-end operations at a pediatrics and adult specialty clinic. The role greets patients, helps maintain efficient and courteous patient flow, and ensures patient demographic and insurance information is complete and accurate. It handles registration for walk-in patients, verifies or updates information, reviews insurance benefits, calculates and collects patient financial responsibility, and follows financial-clearance procedures for non-urgent services when required. The PSR also directs patients who may need financial assistance to a Financial Counselor and completes visit closure, including checkout, follow-up scheduling, collection of applicable balances, and delivery of appropriate documents.

The position maintains current knowledge of payer requirements, pre-authorization and referral requirements, and accepted insurance plans. It communicates customer-service concerns and process-improvement opportunities to management, meets productivity and accuracy expectations, and works collaboratively with patients, families, clinical staff, and other customers.

This is a full-time, 40-hour-per-week position. The usual schedule is Monday through Friday, 8:00 a.m. to 4:30 p.m., with hours that may vary to accommodate clinic operations, including 7:00 a.m. to 3:30 p.m. when opening or 8:30 a.m. to 5:00 p.m. when closing or covering for team members. The work is performed in a normal office environment. The employee must be able to sit for most of the workday, occasionally lift up to 10 pounds, and operate equipment necessary for the job.

Requirements

• High school diploma or GED.
• Ability to identify and understand issues and problems, examine data, and draw logical conclusions from available information.
• Knowledge of and ability to explain Medicare, HIPAA, and EMTALA rules and regulations, and 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 relevant to patient referrals, pre-certification, and authorization processes.
• Ability to communicate effectively with customers or employees and present 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 and 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, including scheduling, registration, and 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 responsibility, 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.
• 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 and reference materials for Medicare, Medicaid, third-party payer requirements, pre-authorization and referral requirements, and 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 and established productivity measurements.
• Maintain positive public relations with patients, families, and clinical staff, and collaborate with others to support concise and 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, possible premium pay, incentive pay for select positions, and opportunity for annual performance-based increases.
• Career development programs and well-being programs.

What This Job Offers

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