Patient Service Representative

Job Description

JOB SUMMARY:

The Patient Services Representative III facilitates all components of patient registration by accurately and efficiently handling the day-to-day operations relating to a patient’s scheduled appointment. This includes obtaining all necessary demographic and financial information to ensure that the most accurate patient data is obtained and populated into the patient record. This role is also responsible for creating a positive patient experience and representing Atrium Health Wake Forest Baptist and partner organizations in a professional manner.

EDUCATION/EXPERIENCE:

• High school diploma or equivalent and three years of experience working in a role within a customer service, fast paced environment with high volume of either calls or in-person requests; or an equivalent combination of education and experience
  
  
  

ESSENTIAL FUNCTIONS:

• Interview patients in-person and/or by phone to obtain all required information for hospital records and billing systems. Pre-registers all scheduled patients for admission, partial hospitalization, and outpatient services according to department policies and procedures.
• Verify insurance coverage and obtains authorization for all services requiring pre-certification.
• Process internal and out-going referrals, as needed, per department procedures
• Perform clerical functions as needed, including answering phones, taking messages, chart processing, faxing and scanning.
• Collect and process upfront deposits or set-up payment arrangements, as required.
• Screen patient for Medicaid, Affordable care Act or hospital sponsored financial program and provides appropriate documentation and referral.
• Assist other team members where necessary
• Adhere to department policies and procedures related to verification of eligibility, benefits, pre-authorization requirements, available payment options, financial counseling and other identified financial clearance related duties
• Complete assigned registration functions within multi-specialty clinic and/or emergency department, which may include claim edit work queues, pre-certifications and authorizations.
• The Patient Services Representative III is expected to sequence multiple physician visits and complete registration activities within multiple registration platforms
• Assists team with escalated issues, trains other team members as needed and is a subject matter expert.
• Participate in departmental performance improvement initiatives
• Other duties as assigned or requested by Supervisor or Manager, such as acting as back up in other departments
• Understand and maintain operations knowledge of Medicare and other state and federal government payor compliance requirements for the population served.
  
  
  

Skills & Qualifications

• EPIC Cadence experience preferred.
• Expert knowledge of patient access services and the overall effect on the revenue cycle.
• A thorough understanding of commercial and government insurance plans, payer networks, government resources and medical terminology.
• Understand and maintain operations knowledge of Medicare and other state and federal government payor compliance requirements for the population served.
• Demonstrated proficiency in communicating effectively with a customer and simplifying complex information.
• Demonstrated ability of critical thinking skills and adhering to compliance protocols.
• Demonstrated ability to handle escalated issues, train/mentor other team members and viewed as a subject matter expert.
• Ability to navigate Internet Explorer and Microsoft Office Suite of applications.
• Experience working in a role that requires prioritization of multiple critical priorities while ensuring quality and achievement of performance metrics.
• Demonstrated ability to meet or exceed performance metrics.
• Ability to handle sensitive information and maintain HIPAA compliance.
  
  
  

WORK ENVIRONMENT:

• Clean, indoor environment
• Minimal travel to clinic locations where assistance is needed
  
  
  

About Us

Atrium Health Wake Forest Baptist is a pre-eminent academic health system based in Winston-Salem, North Carolina. Atrium Health Wake Forest Baptist is part of Advocate Health, which is headquartered in Charlotte, North Carolina, and is the fifth-largest nonprofit health system in the United States, created from the combination of Atrium Health and Advocate Aurora Health. 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.

Wake Forest Baptist Health, Wake Forest University School of Medicine 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.

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