Patient Svc Rep

Advocate Health and Hospitals Corporation•Oshkosh, WI

7d•Onsite

About The Position

The Patient Svc Rep is responsible for creating the initial electronic health record, preventing duplicate records, and ensuring patient safety by verifying identity according to accrediting body mandates. They check in and register patients, collect demographic and insurance information, and discuss/collect co-pays. This role maintains patient confidentiality in accordance with HIPAA. The representative understands insurance basics, AAH contracts, and financial obligations, referring patients to Financial Advocates when necessary. They are knowledgeable about government regulations and required forms such as HIPAA, EMTALA, and Medicare notices, obtaining necessary signatures. The role may involve scheduling appointments, coordinating cancellations/reschedules, and providing detailed information about preparations and procedures. They also perform visit closures, schedule follow-up appointments, and provide after-visit summaries. Maintaining excellent public relations, collaborating with others, and proactively communicating customer service issues are key. The representative creates a welcoming environment, greets patients, answers phones, and offers assistance with transportation, directions, and interpreter services. Advanced duties may include training new staff, patient communications, participating in committees, supporting quality metrics, and editing clinician schedules. They monitor and work 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.

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).
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 clinicians’ schedules.
Monitors and works assigned electronic health record work queues, following the department’s approved process.