Patient Service Representative I AHWFB

aah; South Carolina; On-site; USD 29,000 - 43,000; Part time

Job summary

Advocate Health is seeking a Part-time Patient Access role to greet patients, register walk-ins, verify demographics and insurance, and collect balances. The role supports financial clearance and patient flow, working every other weekend with morning, mid-day, nights, weekends and holidays as needed.

Ideal candidates have a high school diploma or GED and some experience in patient access, scheduling, or insurance verification. Strong communication and confidentiality are essential.

Qualifications

• High school diploma or GED required.
• Experience in patient access, scheduling, registration and financial clearance preferred.
• Knowledge of Medicare, HIPAA, EMTALA rules and regulations; updates on insurance pre-certification requirements.

Responsibilities

• Greets patients arriving for their appointments and manages patient flow.
• Verifies insurance benefits and collects out-of-pocket liability.
• Completes registration for walk-in patients and updates demographic/insurance data.
• Verifies benefits and collects balances or estimates due.
• Follows financial clearance policy and refers to Financial Counselor when needed.
• Maintains knowledge of Medicare/Medicaid/third-party payer requirements.
• Communicates issues to management and strives for 98% accuracy.
• Maintains good relations with patients and staff.

Skills

Communication skills

Medicare rules

HIPAA rules

EMTALA rules

Insurance pre-certification

Anatomy basics

Medical terminology

Pre-certification processes

Authorization processes

Confidentiality

Reading comprehension

Safety rules

Outlook

Word

Excel

ADT software

Problem solving

Work under pressure

Education

High school diploma or GED

Tools

ADT software

Outlook

Word

Excel

Job description

Department:

13348 Enterprise Revenue Cycle - Wake Forest Lexington NC Arrival

Status:

Part time

Benefits Eligible:

No

Hou rs Per Week:

16

Schedule Details/Additional Information:

WORK SCHEDULE: Every Other Weekend FRIDAY SATURDAY SUNDAY. Shift varies morning, mid-day, nights, weekends and holidays

Pay Range:

$20.80 - $31.20

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:

• 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


• 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


• 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


• Identifies 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

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

Our Commitment to You:

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, and Short- 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