Patient Service Representative I

Advocate Health; Rome (GA); On-site; USD 38,000 - 48,000; Full time

Job summary

Advocate Health is seeking a Patient Access Specialist to greet patients, verify demographics, and complete registrations for walk-ins, ensuring accuracy and efficiency in a fast-paced environment.

The role requires knowledge of Medicare, Medicaid, HIPAA rules, and ADT systems, with proficiency in Outlook, Word, and Excel. High school diploma or GED required; healthcare experience preferred.

Qualifications

• High school diploma or GED required; patient access (scheduling, registration and financial clearance), insurance verification, billing or certified medical assistant experience preferred.
• Experience with insurance verification, billing or certified medical assistant roles preferred.
• Proficiency with ADT, Outlook, Word, Excel and patient data systems.

Responsibilities

• Greet patients and manage efficient, courteous flow.
• Verify patient demographic and insurance information.
• Complete registration for walk-in patients.
• Obtain and collect out-of-pocket liability.
• Refer financial assistance needs to Financial Counselor.
• Close visits and schedule follow-ups.
• Maintain knowledge of Medicare, Medicaid and third-party payer requirements.
• Communicate issues to management and meet productivity targets.

Skills

Customer service

Communication skills

Problem solving

Medical terminology

Microsoft Outlook

ADT software

Education

High school diploma or GED

Tools

ADT software

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 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.