Patient Service Representative I AHWFB Pediatrics Lexington

Advocate Aurora Health; Lexington (NC); Presencial; USD 19 000 - 30 000; Tempo integral

Resumo da oferta

Advocate Health is seeking a Patient Access/Registration professional in Lexington, NC to greet patients, verify demographics and insurance, and complete walk-in registrations. You will handle insurance verification, calculate and collect patient liabilities, and refer complex cases to Financial Counselors.

The role requires a high school diploma or GED, familiarity with Medicare/Medicaid requirements, and experience in a fast-paced office environment.

Qualificações

• High school diploma or GED required.
• Patient access including scheduling, registration and financial clearance.
• Experience with insurance verification, billing or as a certified medical assistant preferred.

Responsabilidades

• Greets patients and manages flow to ensure courteous, efficient care.
• Ensures patient demographic and insurance information is complete and accurate.
• Completes registration for walk-ins and updates patient data as needed.
• Verifies insurance benefits and collects out-of-pocket liability.
• Follows Financial Clearance policy when authorization is pending.
• Identifies patients needing financial assistance and refers to Financial Counselor.
• Performs visit closure and schedules follow-ups.
• Maintains knowledge of Medicare/Medicaid and third-party payer requirements.
• Communicates issues to management for service improvement.
• Meets productivity and accuracy targets.

Conhecimentos

Customer service

Communication skills

Medical terminology

HIPAA/EMTALA

Microsoft Outlook

Microsoft Word

Microsoft Excel

Data interpretation

Problem solving

Team collaboration

Formação académica

High school diploma or GED

Ferramentas

ADT software

Descrição da oferta de emprego

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