Patient Service Representative (PSR) - IM/Peds/Family Practice Clinic

Advocate Health and Hospitals Corporation • Franklin, WI

1d • Onsite

About The Position

The Patient Service Representative (PSR) in the IM/Peds/Family Practice Clinic is responsible for creating the initial electronic health record, which serves as the foundation for the patient's medical record used by the entire healthcare team. This role is crucial for preventing duplicate medical records, ensuring patient safety, and facilitating accurate billing. The PSR also handles patient check-in and registration, verifies demographic and insurance information, collects co-pays, and maintains patient confidentiality in accordance with HIPAA. They possess knowledge of insurance basics, understand which plans Advocate Health contracts with, and can discuss financial obligations with patients, referring them to Financial Advocates when necessary. The role requires adherence to government regulations such as HIPAA, EMTALA, and others, involving obtaining necessary patient signatures. Additionally, the PSR may schedule appointments, provide detailed patient information, and manage visit closures. They are expected to maintain excellent public relations, communicate proactively with management, and create a welcoming environment through exceptional customer service. Responsibilities also include answering phones, screening calls, taking messages, and assisting patients with various needs. Advanced duties may include training new staff, participating in committees, supporting quality improvement projects, and editing clinician schedules. The PSR also monitors and works assigned electronic health record work queues.

Requirements

• High School Diploma or GED
• Must be in the PSR I for 12 current months and meet promotion criteria
• 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.
• 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.
• Champion of standardizing practices when new processes are implemented and help trouble shoot challenges.
• 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.
• 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 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.
• Obtains patient or guarantor signatures.
• May schedule patient appointments, including virtual and procedural; 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.
• May perform visit closure, including checking out patients after their visit, scheduling follow-up appointment(s), and providing patients with the after-visit summary.
• 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.
• 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.
• May assist with advanced duties, including but not limited to orientation and training for patient services staff; patient communications, including patient dismissals; participating in committees or quality improvement projects; supporting clinicians’ quality metrics; and editing of clinician’s schedules.
• 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: Full-time
• Career Level: Entry Level
• Education Level: High school or GED