Patient Service Representative

Advocate Health and Hospitals Corporation•Green Bay, WI

12d•Onsite

About The Position

The Patient Service Representative is responsible for greeting and checking in patients, ensuring patient information is complete and accurate, collecting patient responsibility, and completing the registration process. This role involves verifying and updating demographic and insurance information, verifying insurance benefits, calculating patient responsibility, and communicating payment expectations. The representative also identifies patients needing financial assistance, collaborates with Financial Advocates, monitors patient flow, and performs visit closure. Additionally, they schedule patient visits, assist with new caregiver onboarding, work assigned EPIC work queues, and maintain excellent public relations. Proactive communication with management regarding customer service and process improvement is expected. The role requires maintaining knowledge of Medicare, Medicaid, third-party payer requirements, and accepted insurance plans.

Requirements

High School Graduate.
Typically requires 1 year of experience in customer service or clerical/office experience, including answering phones and assisting customers.
Demonstrated ability to identify and understand issues and problems.
Examines data and draws logical conclusions based on information available.
Knowledge and ability to articulate explanations of Medicare/HIPAA/EMTALA rules and regulations and comply with updates on insurance pre-certification requirements.
Mathematical aptitude, effective communication skills and critical thinking skills.
Understanding of basic human anatomy, medical terminology and procedures for application in the patient referral/pre-certification/authorization processes.
Ability to read and interpret documents such as safety rules, operating and maintenance instructions and procedure manuals.
Ability to speak effectively to customers or employees of organization, maintaining a pleasant, professional demeanor.
Ability to handle sensitive and confidential information according to internal policies.
Ability to problem solve in a high profile and high stress area, working independently to set and meet deadlines and prioritize work.
Demonstrated technical proficiency including experience with insurance verification/eligibility tools, EPIC electronic medical record, patient liability estimation tools, Microsoft Office, Internet Explorer and phone technology.

Responsibilities

Greets and checks in patients arriving for their appointments.
Ensures patient information is complete and accurate.
Collects patient responsibility as identified in the pre-registration process.
Completes the registration process on walk-in patients, verifies and/or updates patient demographic and insurance information if changes or additions have occurred.
Verifies insurance benefits, obtains/calculates patient responsibility and request payment.
Communicates to patient the organization expectation of payment at time of service.
Identifies patients in need of financial assistance and refers patients to Financial Advocate when necessary.
Collaborates with Financial Advocate to coordinate patient’s financial resources and responsibilities including requesting patient to sign a Financial Obligation Form (FOF) or Advanced Beneficiary Notice (ABN) as needed.
Monitors patient flow to ensure patients are cared for in the most efficient and courteous manner.
Performs visit closure, including checking out patients, collecting additional patient responsibility (when applicable) and providing patient with appropriate documents.
Schedules patient visits using guidelines established within scheduling system.
Assists with new caregiver onboarding.
Works assigned EPIC work queues, following the department’s work flow process.
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.
Maintains knowledge of and reference materials for Medicare, Medicaid and third-party payer requirements, guidelines and policies, insurance plans requiring pre-authorization/referral and a list of current accepted insurance plans.

Benefits

Comprehensive suite of Total Rewards: benefits and well-being programs
Competitive compensation
Generous retirement offerings
Programs that invest in your career development
Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program