Patient Service Representative, Lexington & Salisbury

Patient Service Representative, Lexington & Salisbury JOB SUMMARY

The Patient Services Representative (PSR) is responsible for completing patient registration duties including collecting and validating accurate patient demographic and insurance information, obtaining pre‑certification or authorization as required, and entering all necessary information into the Atrium Health Wake Forest Baptist (AHWFB) ADT system. The PSR informs patients of their estimated liability, collects patient liabilities, identifies patients in need of financial assistance and refers them to financial counseling as necessary.

The role requires multi‑tasking and effective problem‑solving skills and is expected to foster positive relationships with all patients to provide quality service.

High school diploma or GED required. Preferred: experience with patient access (scheduling, registration and financial clearance), insurance verification, billing or certified medical assistant experience.

• Greets patients arriving for their appointments and 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 for walk‑in patients, verifies and/or updates patient demographics and insurance information when changes occur.
• Verifies insurance benefits, obtains, calculates and collects the patient’s out‑of‑pocket financial liability and requests past‑due, present balances or estimates due.
• Follows the Financial Clearance policy for non‑urgent patient services when financial clearance or authorization has not been completed.
• Identifies patients in need of financial assistance and refers them to the Financial Counselor.
• Performs visit closure, including checking out patients, scheduling follow‑up appointment(s), collecting additional patient responsibility (when applicable) and providing patients with appropriate documents.
• Maintains knowledge of and reference materials for Medicare, Medicaid and third‑party payer requirements, guidelines and policies, insurance plans requiring pre‑authorization/referral and 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.
• Maintains a 98% accuracy rate and meets established department productivity measurements.
• Maintains excellent public relations with patients, families and clinical staff and demonstrates a willingness to work collaboratively with others for concise and timely flow of information.

• Ability to identify and understand issues and problems.
• Examines data and draws logical conclusions based on available information.
• Knowledge of Medicare, HIPAA, EMTALA rules and regulations with compliance to 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 patient referral, pre‑certification and authorization processes.
• Proficient in speaking effectively to customers or employees; presents a pleasant, professional demeanor 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, Excel and ADT software.
• Ability to write routine correspondence, calculate figures and amounts such as discounts and percentages.
• Can work with minimal supervision, solve problems in a high‑profile, high‑stress environment, and interact positively with all internal and external customers while determining work priority.

• 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.

Advocate…