Patient Service Rep 1

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 patients
  
  
  
  
  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:

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  NA
  
  

Education Required:

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  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:

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  NA
  
  

Knowledge, Skills & Abilities Required:

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  ?
  
  
  
  
  
  
  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
  
  



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  Mathematical aptitude, effective oral and written communication skills and critical thinking skills
  
  



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  Understanding of basic human anatomy, medical terminology and procedures for application in the patient referral, pre-certification and authorization processes.
  
  



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  Ability to speak effectively to customers or employees of the organization; presents a pleasant, professional demeanor and image during telephone conversation
  
  



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  Ability to handle sensitive and confidential information according to internal policies
  
  



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  Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals
  
  



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  Experience with Microsoft Outlook, Word and Excel and ADT software
  
  



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  Ability to write routine correspondence, calculate figures and amounts such as discounts and percentages
  
  



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  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:

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  ?Exposed to a normal office environment.
  
  



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  Must be able to sit the majority of the workday.
  
  



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  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.

Advocate Health