Patient Service Representative I AHWFB

aah; Winston-Salem (NC); On-site; USD 43,000 - 65,000; Full time

Benefits offered by this job

Paid Time Off

Health benefits

Flexible Spending Accounts

Retirement plans

Educational Assistance Program

Job summary

Advocate Health seeks a Patient Access representative to greet patients, register walk-ins, verify demographics and insurance, and collect financial responsibilities. You will apply financial clearance policies and refer patients needing aid to the Financial Counselor.

The role requires knowledge of payer rules and strong data-entry skills. Responsibilities include scheduling, follow-up visits, and ensuring accurate information, while maintaining excellent patient relations in a fast-paced

Qualifications

• High school diploma or GED required; patient access and financial clearance experience preferred.
• Knowledge of Medicare, HIPAA and EMTALA rules; up-to-date with pre-cert requirements.
• Strong communication and data-entry skills; proficient with basic office software.

Responsibilities

• Greet patients and manage arrival flow for efficient service.
• Verify and update patient demographics and insurance information.
• Complete walk-in registrations; verify/adjust demographics and insurance as needed.
• Explain and collect patient financial responsibilities; apply financial clearance policies.
• Identify patients needing financial assistance and refer to Financial Counselor.
• Process visit closures and schedule follow-ups; provide necessary documents.
• Maintain knowledge of payer requirements and pre-authorization rules.
• Communicate issues to management to improve service and processes.
• Meet productivity and accuracy targets while maintaining courteous patient relations.

Skills

Medicare knowledge

HIPAA/EMTALA rules

Communication skills

Microsoft Outlook/Word/Excel

ADT software

Attention to detail

Problem solving under pressure

Education

High school diploma or GED

Patient access experience

Medical office/billing experience

Tools

ADT software

Job description

Department:

70000 WFBMG University Group Practice: WFBMC Main - Administration: Ambulatory Services

Status:

Full time

Benefits Eligible:

Yes

Hours Per Week:

40

Schedule Details/Additional Information:

Monday-Friday 8am - 5pm

one hour for lunch

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 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, 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 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.