Patient Svc Rep

Advocate Health; Oshkosh (WI); On-site; USD 32,000 - 42,000; Full time

Job summary

Advocate Health in Oshkosh seeks a Patient Services Associate to create initial electronic health records, verify demographics and insurance, and collect co-pays. You will ensure confidentiality under HIPAA and support billing with accurate information. Strong customer service and accurate data entry are essential.

You will work with EPIC and insurance tools, coordinate appointments, and guide patients through test prep, arrivals, and follow-ups in a fast-paced care setting.

Qualifications

• Knowledge of HIPAA and patient privacy requirements.
• Experience with healthcare front desk tasks and patient data.
• Ability to verify demographics, insurance, and financial information.

Responsibilities

• Create and maintain electronic health records as the patient’s foundation.
• Check in/register patients and collect co-pays and responsibilities.
• Discuss financial information and refer to Financial Advocates when needed.
• Ensure compliance with HIPAA, EMTALA, and privacy notices.
• Schedule appointments and provide test prep and arrival guidance.
• Maintain professional, welcoming environment and strong customer service.
• Handle inquiries, coordinate transportation, and assist with interpreters.
• Operate EHR queues and support department processes.

Skills

HIPAA compliance

Customer service

Attention to detail

Multitasking

Communication skills

Independent work

Problem solving

Team collaboration

Education

High School Diploma or GED

Tools

EPIC

Insurance verification/eligibility tools

Microsoft Office

Internet browser

Phone technology

Job description

Major Responsibilities:

Creates the initial electronic health record that serves as the foundation of the patient medical record that is utilized by all members of the healthcare team. Prevents creation of duplicate medical records that can cause treatment safety issues and billing problems. Follows and ensures compliance with the mandate of the organization’s accrediting bodies to use identifiers to positively identify a patient prior to the delivery of patient care to ensure patient safety.

Checks in and registers patients; obtains and verifies complete demographic, guarantor, and insurance information; discusses and collects co-pays and other out-of-pocket patient responsibilities. Obtaining accurate information at the point of registration helps ensure timely payment to the organization and prevents billing issues and patient complaints. Maintains complete confidentiality regarding patient personal/financial information and medical records in accordance with the Health Insurance Portability and Accountability Act (HIPAA).

Knows insurance basics and recognizes commercial and government plans. Understands which plans AAH contracts with and when a statement of financial responsibility is needed. Understands and discusses financial information and obligations with patients. Knows how and when to refer patients to Financial Advocates.

Has knowledge of which rules, forms and questions must be enforced to make sure AAH remains compliant with government agencies and regulations. Examples are: HIPAA, Emergency Medical Treatment and Active Labor Act (EMTALA), Consent for Treatment, Patient Rights and Responsibilities, Important Message from Medicare (IMM), Medicare Outpatient Observation Notice (MOON), Notice of Privacy Practices, Medicare Secondary Payer Questionnaire (MSPQ), Advanced Beneficiary Notice (ABN). Obtains patient or guarantor signatures as required.

May schedule patient appointments, including virtual and procedural; may also coordinate cancellations, reschedules, wait list requests, and recall requests. Provides accurate, detailed information regarding test preparations, patient arrival time, medication/food/beverage consumption guidelines, check-in procedures, directions to facility, etc. May perform visit closure, including checking out patients after their visit, scheduling follow-up appointment(s), and providing patients with the after-visit summary.

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. Proactively communicates issues involving customer service and process improvement opportunities to management.

Creates a welcoming and professional environment for our patients and visitors by demonstrating extraordinary customer service. Greets patients and visitors and responds to routine requests for information. Answers telephone, screens calls, and takes messages. Offers various assistance to patients to include: arranging transportation needs, providing directions, locating a wheelchair, coordinating interpreter services, etc.

May assist with advanced duties, including but not limited to orientation and training for patient services staff; patient communications, including patient dismissals; participating in committees or quality improvement projects; supporting clinicians’ quality metrics; and editing of clinician’s schedules.

Monitors and works assigned electronic health record work queues, following the department’s approved process.

Licensure, Registration, and/or Certification Required:

None Required.

Education Required:

High School Diploma or GED

Experience Required:

Must be in the PSR I for 12 current months and meet promotion criteria

Knowledge, Skills & Abilities Required:

Demonstrate the Advocate Health purpose, values and behaviors.

Ability to work in a high profile and high stress area, working independently to set and meet deadlines, multitask and prioritize work. Must be able to handle large workloads with many interruptions in a fast-paced environment without direct supervision. May be cross-trained across various specialties and provide staffing support as needed.

Strong attention to detail and accuracy.

Excellent customer service skills in a variety of situations. Must have excellent service recovery skills.

Demonstrated independent thinking and problem-solving skills, ability to exercise judgment to triage issues and concerns. Champion of standardizing practices when new processes are implemented and help trouble shoot challenges.

Excellent communication (written & verbal), customer service and interpersonal skills, ability to effectively communicate with a variety of patients, visitors, staff and physicians in a pleasant professional demeanor.

Educate patients on the insurance coverage aspect of their care including managing the discussion for services that will not or may not be paid by their health plan.

Interact with physicians and their staff to resolve issues related to the patient care.

Collect and manage payments including cash payments, if applicable, and follow security related to cash handling.

Strong understanding and comfort level with computer systems. Demonstrated technical proficiency including experience with insurance verification/eligibility tools, EPIC electronic medical record, patient liability estimation tools, electronic email, Microsoft Office, internet browser and phone technology.

Understanding of basic medical and insurance terms and abbreviations typically used in the patient scheduling and registration process.

HIPAA-compliant and knowledgeable of applicable state and federal rules/regulations. Ability to handle sensitive and confidential information according to internal policies.

General understanding of health insurance: Medicare, Medicaid, managed care, and commercial payers. Knowledge and ability to articulate explanations of Medicare/HIPAA/EMTALA rules and regulations and comply with updates on insurance pre-certification requirements.

Excellent organizational skills.

Demonstrated ability to effectively act as a resource to other teammates.

Physical Requirements and Working Conditions:

This position requires travel, therefore, will be exposed to weather and road conditions.

Operates all equipment necessary to perform the job.

Exposed to a normal office environment with significant patient and public contact. May be exposed to ill or contagious patients.

Must be able to transition from sitting to standing frequently. Must be able to stand and sit for extended periods of time and be physically mobile throughout the workday.

Frequently lifts to 10 lbs. and occasionally lifts 20 lbs. or more. This occurs when moving equipment and supplies and when transporting patients and/or charts.

Must be able to push/pull up to 50 lbs. with assistance.

Sensory requirements include vision, hearing and touch. Must also be able to speak clearly.

Must be able to use hands with fine motor skills for keyboard data entry.

May be asked to work a flexible schedule at times to meet the needs of the department.

DISCLAIMER

All responsibilities and requirements are subject to possible modification to reasonably accommodate individuals with disabilities.

This job description in no way states or implies that these are the only responsibilities to be performed by an employee occupying this job or position.Employees must follow any other job-related instructions and perform any other job-related duties requested by their leaders.