Patient Service Representative Float Pool

Advocate Health; Elkin (NC); On-site; USD 32,000 - 52,000; Full time

Benefits offered by this job

On-site role

Job summary

Advocate Health is seeking a Patient Access Specialist to greet patients, register them, verify insurance, and collect financial responsibilities. The role requires adherence to HIPAA/EMTALA rules and knowledge of Medicare/Medicaid guidelines.

You will coordinate with Financial Counselors to assist patients and ensure accurate, efficient flow through the office. The ideal candidate has experience in a fast-paced medical setting, strong communication skills, and the ability to handle confidential

Qualifications

• High school diploma or GED required.
• Experience in patient access, scheduling, registration, financial clearance, insurance verification, billing or as a certified medical assistant preferred.
• Familiar with Medicare, Medicaid and third-party payer requirements; HIPAA and EMTALA rules.

Responsibilities

• Greet patients arriving for appointments and monitor flow for efficiency and courtesy.
• Verify and complete patient demographics and insurance information.
• Complete walk-in registrations and update demographic/insurance changes.
• Verify insurance benefits and collect patient financial liability, including past due balances.
• Follow financial clearance policies for non-urgent services when needed.
• Identify patients needing financial assistance and refer to Financial Counselor.
• Close visits: check out patients, schedule follow-ups, collect additional patient responsibility, provide documents.
• Maintain knowledge of payer requirements and pre-authorization/referral needs.
• Proactively communicate service issues and process improvement opportunities to management.
• Meet productivity and accuracy targets (e.g., 98% accuracy) and collaborate with staff.

Job description

EDUCATION/EXPERIENCE: High school diploma or GED required. Patient access (scheduling, registration and financial clearance), insurance verification, billing or certified medical assistant experience preferred. REPORTS TO: Supervisor or Manager LICENSURE, CERTIFICATION, and/or REGISTRATION: N/A ESSENTIAL FUNCTIONS: 1. Greets patients arriving for their appointments. Monitors patient flow to ensure patients are cared for in the most efficient and courteous manner. 2. Ensures all patient demographic and insurance information is complete and accurate 3. Completes the registration process on walk-in patients, verifies and / or updates patient demographic and insurance information if changes or additions have occurred 4. Verifies 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 5. 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 6. Identifies patients in need of financial assistance and refers patients to Financial Counselor 7. 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. 8. 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. 9. Proactively communicates issues involving customer service and process improvement opportunities to management 10. Meets productivity requirements to ensure excellent service is provided to customers 11. Meets or exceeds performance expectations of 98% accuracy rate and established department productivity measurements. 12. 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 SKILLS & QUALIFICATIONS: 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 communication 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 WORK ENVIRONMENT: Exposed to a normal office environment. Must be able to sit the majority of the workday. Occasionally lifts up to 10 lbs. Operates all equipment necessary to perform the job