Patient Service Representative (PSR) - Pediatrics and Adult Specialty Clinic

Aurora Health Care; Milwaukee (WI); On-site; USD 22,000 - 30,000; Full time

Job summary

Aurora Health Care is seeking a Patient Access representative to greet patients, register walk-ins, verify insurance and collect balances due. You will ensure accurate demographics, navigate financial clearance, and connect patients with a Financial Counselor when needed.

This on-site role requires strong communication, attention to detail, and the ability to work under pressure while maintaining excellent patient relations and efficient flow of visits.

Qualifications

• High school diploma or GED required; Patient access (scheduling, registration and financial clearance), insurance verification, billing or certified medical assistant experience preferred.
• Ability to identify and understand issues and problems; examine data and draw logical conclusions.
• Knowledge of Medicare, HIPAA, EMTALA rules and insurance pre-certification requirements.
• Strong communication, both written and verbal, with professional demeanor.
• Ability to handle sensitive information and maintain confidentiality.
• Experience with Microsoft Outlook, Word and Excel and ADT software.

Responsibilities

• Greets patients arriving for their appointments and monitors patient flow for efficient service.
• Completes registration for walk-in patients and updates demographic/insurance information.
• Obtains, calculates and collects patient out-of-pocket liability and collects balances due.
• Follows Financial Clearance policy when needed and refers to Financial Counselor for assistance.
• Performs visit closure: checks out patients, schedules follow-ups, and provides documents.
• Maintains knowledge of Medicare, Medicaid, and third-party payer requirements and current accepted insurance plans.
• Communicates issues to management for service and process improvements.
• Meets productivity and accuracy targets within the department.
• Maintains excellent public relations with patients, families, and clinical staff.

Skills

Communication skills

Critical thinking

Mathematical aptitude

Problem solving

Customer service

Attention to detail

Reading comprehension

Education

High school diploma or GED

Tools

Microsoft Outlook

Microsoft Word

Microsoft Excel

ADT software

Job description

• 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

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 GED required. Patient access (scheduling, registration and financial clearance), insurance verification, billing or certified medical assistant experience preferred.

Work Experience Required

• NA

Knowledge, Skills & Abilities Required

• 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

Physical Requirements And Working Conditions

• 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

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.