Patient Svc Rep

Advocate Health•Oshkosh, WI

9d•$21 - $31•Onsite

About The Position

This role is responsible for creating the initial electronic health record, which is crucial for patient safety and billing accuracy. The Patient Service Representative ensures positive patient identification, verifies demographic and insurance information, and collects co-pays. They maintain patient confidentiality in accordance with HIPAA. The position requires knowledge of insurance basics, including commercial and government plans, and the ability to discuss financial obligations with patients, referring them to Financial Advocates when necessary. The role also involves ensuring compliance with various government regulations and obtaining necessary patient signatures. Additionally, the Patient Service Representative may schedule appointments, coordinate cancellations and reschedules, and provide detailed information to patients regarding preparations and procedures. They are expected to maintain excellent public relations, demonstrate collaborative teamwork, and proactively communicate customer service and process improvement opportunities. A welcoming and professional environment is to be created through extraordinary customer service, greeting patients, responding to requests, answering the telephone, and offering various forms of assistance. Advanced duties may include training new staff, patient communications, participating in committees, supporting quality improvement projects, and assisting with clinician schedules. The role also involves monitoring and working assigned electronic health record work queues.

Requirements

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.
Must be able to transition from sitting to standing frequently.
Must be able to stand and sit for extended periods of time and be physically mobile throughout the workday.
Frequently lifts to 10 lbs. and occasionally lifts 20 lbs. or more.
Must be able to push/pull up to 50 lbs. with assistance.
Sensory requirements include vision, hearing and touch.
Must also be able to speak clearly.
Must be able to use hands with fine motor skills for keyboard data entry.
May be asked to work a flexible schedule at times to meet the needs of the department.

Responsibilities

Creates the initial electronic health record that serves as the foundation of the patient medical record.
Prevents the creation of duplicate medical records.
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.
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 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 (e.g., HIPAA, EMTALA, Consent for Treatment, Patient Rights and Responsibilities, IMM, MOON, Notice of Privacy Practices, MSPQ, ABN).
Obtains patient or guarantor signatures as required.
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.
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

Comprehensive suite of Total Rewards: benefits and well-being programs
Competitive compensation
Generous retirement offerings
Programs that invest in your career development
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