Patient Service Representative - Urgent Care

Advocate Health; Oshkosh (WI); On-site; USD 19,000 - 28,000; Full time

Job summary

Advocate Health in Oshkosh, WI is seeking a patient access representative to greet patients and manage registrations. You will verify demographics, insurance, and referrals, and assist with financial clearance and billing information to support smooth clinic flow.

The role requires high school diploma or GED, strong communication skills, and proficiency with Outlook/Word/Excel and ADT software. You will work in a fast-paced environment with collaboration across teams.

Qualifications

• High school diploma or GED required; patient access experience preferred.
• Proficient in Microsoft Outlook, Word and Excel; ADT software experience.
• Ability to interpret Medicare, HIPAA and EMTALA rules; strong communication.
• Ability to work with minimal supervision in a high-stress environment.

Responsibilities

• Greet patients and manage patient flow.
• Verify demographic and insurance information for accuracy.
• Complete walk-in registrations and update records.
• Obtain and collect out-of-pocket liabilities and balances.
• Refer financial questions to Financial Counselor.
• Handle visit closure and schedule follow-ups.
• Maintain knowledge of Medicare/Medicaid and payer requirements.
• Escalate service issues to management.
• Meet productivity and accuracy targets.
• Maintain professional relations with patients and staff.

Skills

Analytical thinking

Medicare knowledge

Communication

Critical thinking

Medical terminology

Professional demeanor

Confidentiality

Reading comprehension

Outlook

Word

Excel

ADT software

Billing knowledge

Problem solving

Education

High school diploma or GED

Tools

ADT software

Microsoft Outlook

Microsoft Word

Microsoft Excel

Job description

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 GEDrequired. Patient access (scheduling,registrationand 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 communications 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 upto 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.