Patient Service Representative

Advocate Health; Cartersville (GA); On-site; USD 21,000 - 26,000; Full time

Job summary

Advocate Health in Cartersville, GA seeks a Patient Access Clerk to greet patients, verify demographics, and manage registrations with accuracy and courtesy. You will determine insurance details, collect out-of-pocket liabilities, and coordinate financial clearance for non-urgent visits.

Responsibilities include completing walk-in registrations, updating records, scheduling follow-ups, and ensuring compliance with Medicare/Medicaid and payer rules.

Qualifications

• High school diploma or GED required; patient access (scheduling, registration and financial clearance), insurance verification, billing or certified medical assistant experience preferred.

Responsibilities

• Greets patients and manages flow for efficient service.
• Ensures patient demographics and insurance data are complete and accurate.
• Completes walk-in registrations and updates demographic information.
• Calculates and collects out-of-pocket liability; collects balances or estimates due.
• Adheres to Financial Clearance policies for non-urgent services when needed.
• Assists patients needing financial counseling and refers to Financial Counselor.
• Schedules follow-up appointments and completes visit closure with documents.
• Maintains knowledge of Medicare, Medicaid and third-party payer requirements.
• Communicates issues to management for process improvement.
• Meets productivity and accuracy targets and maintains professional demeanor.

Skills

Communication skills

Medicare rules

HIPAA compliance

EMTALA rules

Medical terminology

Problem solving

Education

High school diploma or GED

Tools

ADT software

Microsoft Outlook

Microsoft Word

Microsoft Excel

Job description

Major Responsibilities:

• Greets patients arriving for their appointments. Monitors patient flow to ensure patients are cared for in the most efficient and courteous manner.
• Ensures all patient demographic and insurance information is complete and accurate
• Completes the registration process on walk-in patients, verifies and / or updates patient demographic and insurance information if changes or additions have occurred
• insurance benefits. Obtains, calculates and collects the patient’s out of pocket financial liability. Requests and collects past due and present balances or estimates due
• Follows the Financial Clearance policy for non-urgent patient services if financial clearance has not been completed or authorization has not been obtained, when appropriate
• patients in need of financial assistance and refers patients to Financial Counselor
• Performs visit closure, including but not limited to checking out patients, scheduling follow-up appointment(s), collecting additional patient responsibility (when applicable) and providing patient with appropriate documents.
• Maintains knowledge of and reference materials of the following: Medicare, Medicaid and third-party payer requirements, guidelines and policies, insurance plans requiring pre-authorization/referral and a list of current accepted insurance plans.
• Proactively communicates issues involving customer service and process improvement opportunities to management
• Meets productivity requirements to ensure excellent service is provided to customers
• Meets or exceeds performance expectations of 98% accuracy rate and established department productivity measurements.
• 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

Licensure, Registration, and/or Certification Required:

• NA

Education Required:

• High school diploma or GEDrequired. Patient access (scheduling,registrationand financial clearance), insurance verification, billing or certified medical assistant experience preferred.

Work Experience Required:

• NA

Knowledge, Skills & Abilities Required:

• 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, and EMTALA rules and regulations and comply with updates on insurance pre-certification requirements
• Mathematical aptitude, effective oral and written communications skills and critical thinking skills
• Understanding of basic human anatomy, medical terminology and procedures for application in the patient referral, pre-certification and authorization processes.
• Ability to speak effectively to customers or employees of the organization; presents a pleasant, professional demeanor and image during telephone conversation
• Ability to handle sensitive and confidential information according to internal policies
• Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals
• Experience with Microsoft Outlook, Word and Excel and ADT software
• Ability to write routine correspondence, calculate figures and amounts such as discounts and percentages
• Must be able to work with minimal supervision, to problem solve in a high profile and high stress area and interact positively with all internal and external customers while possessing the ability to determine priority of work

Physical Requirements and Working Conditions:

• Exposed to a normal office environment.
• Must be able to sit the majority of the workday.
• Occasionally lifts upto 10 lbs.
• Operates all equipment necessary to perform the job

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.