Patient Services Representative II

Department:70000 WFBMG University Group Practice: WFBMC Main - Administration: Ambulatory ServicesStatus: Full timeBenefits Eligible:YesHours Per Week:40Schedule Details/Additional Information:Monday through Friday 7:30 am until 4:30 pmPay Range$21.85 - $32.80EDUCATION/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 REPORTS TO: Supervisor, Clinic Registration LICENSURE, CERTIFICATION, and/or REGISTRATION: N/A 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 PHYSICAL REQUIREMENTS: Amount of time spent performing the following activities:0%35%65%tototo35%65%100%N/AActivityXStandingXWalkingXSittingXBendingXReaching with armsXFinger and hand dexterityXTalkingXHearingXSeeingLifting, carrying, pushing and or pulling:X20 lbs. maximumX50 lbs. maximumX100 lbs. maximum Our Commitment to You:Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including:CompensationBase compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or trainingPremium pay such as shift, on call, and more based on a teammate's jobIncentive pay for select positionsOpportunity for annual increases based on performanceBenefits and morePaid Time Off programsHealth and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term DisabilityFlexible Spending Accounts for eligible health care and dependent care expensesFamily benefits such as adoption assistance and paid parental leaveDefined contribution retirement plans with employer match and other financial wellness programsEducational Assistance ProgramNote: Eligibility for programs listed above may depend on your FTE or status (e.g., full-time, part-time, per diem, temporary, etc.); please ask a Recruiter for more information during an interview.About Advocate Health Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its e