Patient Services Representative I, Ophthalmology

ARVO; High Point (NC); On-site; USD 35,000 - 45,000; Full time

Job summary

A leading healthcare provider is looking for a Patient Services Representative in High Point, NC. The role involves managing patient registrations, verifying insurance, and providing assistance regarding financial liabilities. The ideal candidate should possess critical thinking skills and experience in patient access. Join a team committed to improving health and advancing healing for all.

Qualifications

• Strong understanding of Medicare and HIPAA regulations.
• Ability to articulate explanations of insurance pre-certification requirements.
• Experience with patient access and registration preferred.

Responsibilities

• Complete patient registration duties and validate insurance information.
• Collect patient liabilities and refer those needing financial assistance.
• Ensure excellent public relations and address customer service issues.

Skills

Effective communication

Critical thinking

Mathematical aptitude

Education

High school diploma or GED

Tools

Microsoft Outlook

Microsoft Word

Microsoft Excel

ADT software

Job description

JOB DESCRIPTION

JOB SUMMARY:

The Patient Services Representative (PSR) is responsible for completing patient registration duties including but not limited to collecting and validating accurate patient demographic and insurance information, obtaining pre-certification or authorization as required, and entering all necessary information into Wake Forest Baptist Medical Center (WFBMC) ADT system. The PSR is responsible for informing the patient of their estimated liability, collecting patient liabilities, identifying patients in need of financial assistance and referring patients to financial counseling as necessary. This position requires multi-tasking and effective problem solving skills. It is expected that the PSR will foster positive relationships with all patients in an effort to provide quality service.

EDUCATION/EXPERIENCE:

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

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

About Us

Atrium Health Wake Forest Baptist is a pre-eminent academic health system based in Winston-Salem, North Carolina. Atrium Health Wake Forest Baptist is part of Advocate Health, which is headquartered in Charlotte, North Carolina, and is the fifth-largest nonprofit health system in the United States, created from the combination of Atrium Health and Advocate Aurora Health. Atrium Health Wake Forest Baptist's two main components are an integrated clinical system - anchored by Atrium Health Wake Forest Baptist Medical Center, an 885-bed tertiary-care hospital in Winston-Salem - that includes Brenner Children's Hospital, five community hospitals, more than 300 primary and specialty care locations and more than 2,700 physicians; and Wake Forest School of Medicine, the academic core of Atrium Health Enterprise and a recognized leader in experiential medical education and groundbreaking research that includes Wake Forest Innovations, a commercialization enterprise focused on advancing health care through new medical technologies and biomedical discovery.

Wake Forest Baptist Health, Wake Forest University School of Medicine and Atrium Health have joined forces in a strategic combination that will enhance care, transform medical education and create economic opportunity for countless lives in North Carolina and beyond. As a part of that combination, the two health systems will be integrating technology and platforms, including our career sites.

This means that although you are applying on the Wake Forest Baptist Health Career Site, you receive communications from the Atrium Health Recruitment Team. Please know that this is an expected process, and thanks in advance for your flexibility.

About the Team

Mission, Vision and Culture Commitments

Mission

To improve health, elevate hope and advance healing - for all.

Vision

To be the first and best choice for care.

Culture Commitments

We create a space where all Belong

We Work as One to make great things happen

We earn Trust in all we do

We Innovate to better the now and create the future

We drive for Excellence - always