Patient Service Representative - Pre Registration

Atrium Health; Charlotte (NC); Remote; USD 60,000 - 80,000; Full time

Job summary

A nonprofit health system is seeking a Patient Access Specialist to provide exceptional service while managing patient registrations and insurance information. The position requires a high school diploma and 2 years of related experience. Strong communication and negotiation skills are essential for success. This full-time remote position offers a competitive salary, benefits, and career development opportunities.

Benefits

Paid Time Off

Medical, dental, and vision insurance

Flexible Spending Accounts

Educational Assistance Program

Qualifications

• 2 years of experience in Patient Access or related fields.
• Intermediate math skills required.

Responsibilities

• Perform duties conforming to customer service philosophy.
• Greet and acknowledge all patients.
• Collect patient demographic and insurance information.
• Notify relevant teams regarding uninsured patients.
• Maintain knowledge of insurance requirements.

Skills

Typing

Data entry proficiency

Communication skills

Negotiation skills

Education

High School Diploma

Job description

Overview

Department: 13360 Enterprise Revenue Cycle - Patient Access: Corporate

Status: Full time

Benefits Eligible: Yes

Hours Per Week: 40

Schedule Details/Additional Information: Remote position, full-time, 40 hours per week

Pay Range

$20.40 - $30.60

Major Responsibilities

• Responsible for performing all job duties in a way that conforms to our customer service philosophy and consistent with our "AIDET" standards
• Greet and Acknowledge all patients and family members in a welcoming and prompt manner.
• Introduce the patient to our services, what they can expect while under our care. Utilize appropriate etiquette in all communications.
• Provide the patient with information on the likely time spent in the service area (duration) including time in registration and time in clinical service.
• Explain the nature of our work, why we ask for demographic, socio-economic, and financial information. Explain how we safeguard their information and use it to provide better care for them.
• Hand-patients off to the next area with a clear "thank you."
• When creating new registrations for walk-in patients, identify insurance coverage, benefits available, patient out-of-pocket expenses, and collect co-insurance and co-payments.
• Collect appropriate out of pocket expenses in accordance with policy.
• Use electronic systems to confirm coverage while the patient is present and discuss findings with the patient. Follow department policies to resolve issues related to eligibility or in-network status within Advocate's network.
• When working uninsured patients, screen for urgent status cases and follow charity procedure. Refer for additional financial counseling as needed and engage leaders to resolve questions on urgent versus non-urgent/elective care.
• When assisting walk-in patients, screen orders for policy compliance. Communicate with physicians, Care Coordinators, and clinical department leaders to resolve issues related to order quality and acceptable standards.
• Responsible for security authorization and precertification of inpatient and outpatient services.
• Notify Financial Counseling, physicians, Care Coordinators, and Utilization Management on cases where patients are uninsured, or where only third-party liability or workers compensation applies.
• Maintain knowledge of all stand-alone computer software programs to verify eligibility.
• Identify at risk balances related to Medicare co-days, lifetime reserve days and other Medicare coverage limits and communicate to Financial Counseling, UM and physicians.
• Identify at risk balances related to Medicaid eligibility rules and communicate to Financial Counseling, UM and physicians.
• Initiate communication to patient when authorization is not obtained and explain potential financial impact and patient responsibility for unauthorized services.
• Accurately collect and analyze clinical data in support of prior authorization and precertification as required by payor guidelines.
• Acquire and maintain current knowledge of all insurance requirements as it relates to patient/hospital responsibility and hospital billing.
• Stay current on Federal and State regulations regarding billing.
• Ensure completion of all established policies and procedures for identification and notification of the Primary Care Physician in the case of HMO coverage plans.
• Inform Financial Counseling, physicians, Care Coordinators and UM of out of network or noncovered service limitations of managed care/commercial insurance where benefits are at risk.
• Pre-registration and registration accuracy: entry of patient demographic and insurance information in the ADT system, pre-registers and registers patients for all units, provides education to patients about documents to be signed, manages calls to complete pre-registrations, and processes required documents for completion of each registration.
• Participates in departmental team building, in-services, and other duties as assigned by leader, including contributing to quality initiatives, attending required in-services, and assisting leadership with special assignments.

Education/Experience Required

• High School Diploma with 2 years of experience in Patient Access or related fields such as medical office support, billing, insurance, hospitality, or call center. Intermediate math skills.

Knowledge, Skills & Abilities Required

• Typing 25 WPM; basic understanding of web-based systems; proficiency in data entry

Physical Requirements and Working Conditions

• Ability to prioritize and organize workload; strong communication and negotiation skills; independent decision making; ability to work flexible hours including evenings, weekends and holidays; ability to work as a team member.
• Physically able to sit, stand, walk, lift, carry, squat, bend, twist, rotate, and kneel; frequent lifting up to 10 lbs and occasional lifting 20 lbs or more; push/pull up to 50 lbs with assistance; functional speech and hearing; fine motor skills for keyboard data entry; normal office environment; operation of required equipment; flexible schedule to support department needs.

Addendum

Offsite imaging center registrars: performs additional activities to facilitate patient flow including CPOE for exams, light-duty cleaning of changing areas, printing and distributing results CDs with HIPAA considerations, and escorting patients to changing areas as needed. This description reflects general duties and may include other related responsibilities as required.

Our Commitment to You

Advocate Health offers a comprehensive suite of Total Rewards, including benefits and well-being programs, compensation, retirement offerings, and career development opportunities.

Compensation

• Base compensation within the listed range based on qualifications and experience
• Premium pay such as shift differentials
• Incentive pay for select positions
• Opportunity for annual increases based on performance

Benefits and more

• Paid Time Off; medical, dental, vision, life, and short- and long-term disability
• Flexible Spending Accounts; family benefits such as adoption assistance and paid parental leave
• Defined contribution retirement plans with employer match
• Educational Assistance Program

About Advocate Health

Advocate Health is a large nonprofit health system providing care under multiple brand names across the United States, with a focus on clinical innovation, outcomes, and value-based care. It employs thousands of teammates and operates numerous hospitals and care locations. It is committed to equitable care and community benefits.