Patient Service Representative (PSR) - IM/Peds/Family Practice Clinic

Major Responsibilities:

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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 organizations accrediting bodies to use identifiers to positively




identify




a patient prior to the delivery of patient care to ensure patient safety




.

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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)




.

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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.

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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




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May schedule patient appointments




, including virtual and procedu




r




al




; 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.

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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.






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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




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Answers telephone,




screens calls, and takes messages




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Offers various




assistance




to patients to




include:




arranging transportation needs, providing directions,




locating




a wheelchair, coordinating interpreter services, etc.

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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




;




support




ing






clinicians




quality metrics




;






and




editing of clinicians schedules




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Monitors and works assigned electronic health record work




queues, following




the departments approved process.

Licensure, Registration, and/or Certification Required:

None Required.

Education Required:

High School Diploma or GED

Experience Required:






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

Knowledge, Skills & Abilities Required:

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Demonstrate the Advocate Health purpose, values and behaviors.

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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.






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Strong attention to detail and accuracy.






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Excellent customer service skills in a variety of situations




.




Must have excellent service recovery skills.






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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.

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






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HIPAA-compliant and knowledgeable of applicable state and federal rules/regulations




.




Ability to handle sensitive and confidential information according to internal policies.






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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.






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Excellent organizational skills.

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Demonstrated ability to effectively act as a resource to other




teammates




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Physical Requirements and Working Conditions:

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






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Operates all equipment necessary to perform the job.






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Exposed to a normal office environment




with significant patient and public contact




.




May be exposed to ill or contagious patients.






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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.






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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.






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




assistance




.






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Sensory requirements include vision, hearing and touch




.




Must also be able to speak




clearly.

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

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May be




asked




to




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






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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.

Advocate Health