Patient Service Representative - Hospital

A Patient Service Representative (PSR) is often a patient’s first impression of Advocate Health and frequently is the starting point and foundation for all Revenue Cycle functions. That work includes complete and accurate capture of information related to patient demographics, insurance coverage, and patient financial responsibility. The PSR helps prevent the loss of revenue and impacts operating margins through the accuracy and timeliness of their workflows.

The PSR ensures mandated regulations are followed and patient satisfaction is optimized. The PSR plays a crucial role in connecting a variety of departments for the overall success of the patient’s experience and the organization’s financial success. Often works without direct supervision present.

Major Responsibilities:

• Creates the initial electronic health record that serves as the foundation of the patient medical record that is utilized by all members of the healthcare team. Prevents creation of duplicate medical records that can cause treatment safety issues and billing problems. Follows and ensures compliance with the mandate of the organization’s accrediting bodies to use identifiers to positively identify a patient prior to the delivery of patient care to ensure patient safety.

• Checks in and registers patients; obtains and verifies complete demographic, guarantor, and insurance information; discusses and collects co-pays and other out-of-pocket patient responsibilities. Obtaining accurate information at the point of registration helps ensure timely payment to the organization and prevents billing issues and patient complaints. Maintains complete confidentiality regarding patient personal/financial information and medical records in accordance with the Health Insurance Portability and Accountability Act (HIPAA).

• Knows insurance basics and recognizes commercial and government plans. Understands which plans Advocate Health contracts with and when a statement of financial responsibility is needed. Understands and discusses financial information and obligations with patients. Knows how and when to refer patients to Financial Advocates.

• Has knowledge of which rules, forms and questions must be enforced to make sure Advocate Health remains compliant with government agencies and regulations. Examples are HIPAA, Emergency Medical Treatment and Active Labor Act (EMTALA), Consent for Treatment, Patient Rights and Responsibilities, Important Message from Medicare (IMM), Medicare Outpatient Observation Notice (MOON), Notice of Privacy Practices, Medicare Secondary Payer Questionnaire (MSPQ), Advanced Beneficiary Notice (ABN).
  
  Obtains patient or guarantor signatures as required.

• May schedule patient appointments: may also coordinate cancellations, reschedules, wait list requests, and recall requests. Provides accurate, detailed information regarding test preparations, patient arrival time, medication/food/beverage consumption guidelines, check-in procedures, directions to facility, etc.

• Creates a welcoming and professional environment for our patients and visitors by demonstrating extraordinary customer service. Greets patients and visitors and responds to routine requests for information. Answers telephone, screens calls, and takes messages. Offers various assistance to patients to include arranging transportation needs, providing directions, locating a wheelchair, coordinating interpreter services, etc.

• Monitors and works assigned electronic health record work queues, following the department’s approved process.

Licensure, Registration, and/or Certification

Required:

• ​​None

Education Required:

• ​​High School Graduate. ​

Experience

Required:

• None

Knowledge, Skills & Abilities

Required:

• Demonstrate the Advocate Health purpose, values and behaviors.

• Ability to work in a high profile and high stress area, working independently to set and meet deadlines, multitask and prioritize work. Must be able to handle large workloads with many interruptions in a fast-paced environment without direct supervision.

• Strong attention to detail and accuracy.

• Excellent customer service skills in a variety of situations. Must have excellent service recovery skills.

• Demonstrated…