Patient Svc Rep I Hospital

American Addiction Centers•West Allis, WI

22h•Onsite

About The Position

The Patient Service Representative I in the Hospital setting is responsible for creating and maintaining the initial electronic health record, which is crucial for patient medical records and utilized by the entire healthcare team. This role is vital in preventing duplicate medical records, ensuring patient safety through positive identification, and maintaining compliance with accrediting bodies. Key duties include patient check-in and registration, obtaining and verifying demographic, guarantor, and insurance information, and discussing/collecting co-pays and other patient financial responsibilities to ensure timely payments. The representative must maintain strict confidentiality in accordance with HIPAA, understand various insurance plans (commercial and government), and know when to refer patients to Financial Advocates. They are also responsible for enforcing compliance with government agencies and regulations such as EMTALA, Consent for Treatment, Patient Rights, IMM, MOON, Notice of Privacy Practices, MSPQ, and ABN, and obtaining necessary patient signatures. Additional responsibilities may include scheduling appointments, coordinating cancellations/reschedules, and providing detailed information regarding test preparations and facility directions. The role requires creating a welcoming and professional environment, greeting patients and visitors, responding to inquiries, answering phones, and offering assistance like arranging transportation or interpreter services. They also monitor and manage electronic health record work queues. Advocate Health, the employer, is the third-largest nonprofit, integrated health system in the United States, committed to clinical innovation, health outcomes, consumer experience, and value-based care, serving nearly 6 million patients across 69 hospitals and over 1,000 care locations.

Requirements

High School Graduate.
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.
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 patient care.
Collect and manage payments including cash payments 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 staff.

Nice To Haves

Experience with insurance verification/eligibility tools, EPIC electronic medical record, patient liability estimation tools, electronic email, Microsoft Office, Internet and phone technology.

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 Advocate Health 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 Advocate Health remains compliant with government agencies and regulations.
Obtains patient or guarantor signatures as required.
May schedule patient appointments: 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.
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.
Monitors and works assigned electronic health record work queues, following the department’s approved process.

Benefits

Comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more.
Compensation Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training.
Premium pay such as shift, on call, and more based on a teammate's job.
Incentive pay for select positions.
Opportunity for annual increases based on performance.
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.