Patient Service Representative Winston-Salem PRN

Patient Service RepresentativeWinstonSalem

PRN variable shift (Days and Weekends)

Wake Forest Baptist Health is a preeminent academic health system based in WinstonSalem North Carolina. Wake Forest Baptists two main components are an integrated clinical system anchored by Wake Forest Baptist Medical Center an 885bed tertiarycare hospital in WinstonSalem that includes Brenner Childrens Hospital five community hospitals more than 350 primary and specialty care locations and more than 2500 physicians; and Wake Forest School of Medicine 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.

Performs a variety of duties associated with patient registration scheduling checkout operations and cash collections. Presents a positive friendly and caring attitude to patients and staff throughout the Medical Center.

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 precertification or authorization as required and entering all necessary information into Wake Forest Baptist Health (WFBH) 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 multitasking 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. Bilingual preferred.

EDUCATION/EXPERIENCE:

High School Diploma or GED required and three years of healthcare or customer service experience. 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 walkin patients verifies and / or updates patient demographic and insurance information if changes or additions have occurred
• Verifies insurance benefits. Obtains calculates and collects the patients out of pocket financial liability. Requests and collects past due and present balances or estimates due
• Follows the Financial Clearance policy for nonurgent 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 followup 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 thirdparty payer requirements guidelines and policies insurance plans requiring preauthorization/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 precertification 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 precertification 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