Patient Service Representative I

Advocate Aurora Health; Cartersville (GA); On-site; USD 28,000 - 41,000; Full time

Benefits offered by this job

Paid Time Off

Health benefits

FSA

Adoption assistance

Retirement plan

Educational assistance

Job summary

Advocate Health is seeking a patient access specialist to greet patients, verify demographics and insurance, and complete registrations for walk-ins. You will manage out-of-pocket payments, follow financial clearance procedures, and refer complex cases to a Financial Counselor.

Collaboration with clinical staff ensures smooth patient flow and accurate documentation. The role emphasizes excellent customer service, adherence to payer policies, and meeting productivity and accuracy targets in a

Qualifications

• High school diploma or GED required; CMA experience preferred
• Experience with patient access, scheduling, registration and financial clearance
• Familiarity with Medicare, Medicaid, and third-party payer policies.

Responsibilities

• Greet patients and manage patient flow efficiently and courteously
• Verify and update patient demographics and insurance information
• Complete registration for walk-in patients
• Explain and collect out-of-pocket amounts and balances
• Support financial clearance and refer to Financial Counselor when needed
• Close visits and schedule follow-ups
• Maintain knowledge of payer requirements and pre-authorization rules
• Meet productivity and accuracy targets
• Provide excellent patient relations and collaborate with staff

Skills

Problem solving

Medicare rules

Communication

Critical thinking

Anatomy & terminology

Customer communication

Data privacy

Education

High school diploma or GED

Tools

Microsoft Outlook

Microsoft Word

Microsoft Excel

ADT software

Job description

Department: 01220 HC Cartersville MOB 150 Gentilly Blvd - Internal Medicine

Status: Full time

Benefits Eligible: Yes

Hou rs Per Week: 40

Schedule Details/Additional Information:

Monday through Friday, 7:00 am to 4:00 pm

Pay Range: $19.80 - $29.70

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 toidentifyand 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 andcomply withupdates on insurance pre-certification requirements
• Mathematical aptitude, effective oral and written communicationskillsand critical thinking skills
• Understanding ofbasic human anatomy, medicalterminologyand procedures for application inthe patientreferral, pre-certificationand 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,operatingand 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, toproblem solvein a high profile and high stress area and interact positively with all internal and external customers whilepossessingthe ability todeterminepriority of work

Physical Requirements and Working Conditions:

• Exposed to a normal office environment.
• Must be able tositthe majority ofthe workday.
• Occasionallylifts 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.

Our CommitmenttoYou:

Advocate Health offers a 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 – so you can live fully at and away from work, including:

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

Benefits and more

• Paid Time Off programs
• Health and welfare benefits such as medical, dental, vision, life, andShort- 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

Note: Eligibility for programs listed above may depend on your FTE or status (e.g., full-time, part-time, per diem, temporary, etc.); please ask a Recruiter for more information during an interview.

About Advocate Health

Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.