Patient Service Representative

About the Role

Patient Service Representative at Aurora Health Care.

Key Responsibilities

• Creates the initial electronic health record, ensuring it is the foundation for all healthcare team members and preventing duplicate records.
• Ensures patient safety by verifying positive patient identification before care delivery, in compliance with organizational mandates.
• Checks in and registers patients, obtaining and verifying demographic, guarantor, and insurance information.
• Discusses and collects co-pays and other patient financial responsibilities.
• Maintains patient confidentiality in accordance with HIPAA.
• Understands insurance basics, commercial and government plans, and Advocate Health contracts.
• Determines when a statement of financial responsibility is needed and discusses financial information with patients.
• Refers patients to Financial Advocates when necessary.
• Ensures compliance with government agencies and regulations such as HIPAA, EMTALA, Consent for Treatment, Patient Rights and Responsibilities, IMM, MOON, Notice of Privacy Practices, MSPQ, and ABN.
• Obtains required patient or guarantor signatures.
• May schedule patient appointments, coordinate cancellations, reschedules, wait list, and recall requests.
• Provides accurate information regarding test preparations, arrival times, medication/food/beverage guidelines, check-in procedures, and directions.
• Creates a welcoming and professional environment through extraordinary customer service.
• Greets patients and visitors, and responds to routine information requests.
• Answers telephones, screens calls, and takes messages.
• Assists patients with needs such as transportation, directions, wheelchairs, and interpreter services.
• Monitors and works assigned electronic health record work queues according to department processes.

Requirements & Tech Stack

• Demonstrates Advocate Health purpose, values, and behaviors.
• Ability to work independently in high-profile, high-stress areas, setting and meeting deadlines, multitasking, and prioritizing work.
• Capacity to handle large workloads with interruptions in a fast-paced environment without direct supervision.
• Strong attention to detail and accuracy.
• Excellent customer service and service recovery skills.
• Demonstrated independent thinking and problem-solving skills, with the ability to exercise judgment.
• Excellent communication (written & verbal), customer service, and interpersonal skills.
• Ability to effectively communicate with a variety of individuals in a pleasant, professional demeanor.
• Educates patients on insurance coverage aspects of their care.
• Interacts with physicians and staff to resolve patient care issues.
• Collects and manages payments, including cash, and follows cash handling security procedures.
• Strong understanding and comfort 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
• Phone technology
• Understanding of basic medical and insurance terms and abbreviations.
• HIPAA-compliant and knowledgeable of applicable state and federal rules/regulations.
• Ability to handle sensitive and confidential information.
• 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 insurance pre-certification requirements.
• Excellent organizational skills.
• Ability to effectively act as a resource to other staff.

Physical Requirements and Working Conditions

• May require travel, exposing the individual to weather and road conditions.
• Responds quickly to patient medical status and emergency situations in clerical areas.
• CPR certification may be required based on service location.
• Notary training/licensure may be required.
• Operates all necessary equipment.
• 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 and be physically mobile throughout the workday.
• Frequently lifts up to 10 lbs, occasionally lifts 20 lbs or more.
• Must be able to push/pull up to 50 lbs with assistance (e.g., moving equipment, transporting patients).
• Escorts patients to nursing units or outpatient departments as necessary.
• Sensory requirements include vision, hearing, and touch; ability 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.

Qualifications

• High School Graduate.

Preferred Job Requirements

• Experience with insurance verification/eligibility tools, EPIC electronic medical record, patient liability estimation tools, electronic email, Microsoft Office, Internet, and phone technology.