Patient Service Representative, Financial Clearance

Company: Atrium Health
Location: Winston Salem
Posted on: May 25, 2023

Job Description:

Job Description

Patient Service Representative, Financial Clearance

40 hours per week, day shift

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 Atrium Health Wake Forest Baptist (AHWFB) 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.

LICENSURE, CERTIFICATION, and/or REGISTRATION:

N/A

ESSENTIAL FUNCTIONS:

• 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
• 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
• 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
• Identifies 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
  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
      
      Wake Forest Baptist Health 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.
      
      Atrium Health Wake Forest Baptist is a pre-eminent academic health system based in Winston-Salem, North Carolina and part of Atrium Health Enterprise. 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.
      
      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

Keywords: Atrium Health, Winston-Salem , Patient Service Representative, Financial Clearance, Sales , Winston Salem, North Carolina