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Patient Service Representative

2 months ago

Aurora, Illinois, United States Advocate Health Full time
Job Summary

We are seeking a highly organized and detail-oriented Patient Service Representative to join our team at Advocate Health. As a Patient Service Representative, you will play a critical role in ensuring the smooth operation of our healthcare services.

Key Responsibilities
  • Order Confirmation and Billing

Confirm patient orders and process billing for medical equipment and supplies. Ensure accurate and timely billing to maximize revenue recognition.

Paperwork Review and Processing

Review and process paperwork submitted with equipment set up packets to ensure completeness, accuracy, and compliance with regulatory requirements.

Safety Issue Resolution

Investigate and resolve safety issues documented by drivers, ensuring prompt communication with patients, physicians, and management as needed.

Service Maintenance and Scheduling

Process service maintenance tickets and schedule future service and maintenance for rental equipment.

Knowledge of Healthcare Regulations

Maintain knowledge of Medicare, Medicaid, HMO, Managed Care, PHO, and Advocate contract procedures and guidelines.

Authorization Verification

Verify current and appropriate authorizations for all managed care clients for supplies and purchased items.

Reimbursement Identification and Verification

Identify and verify sources of reimbursement for patients with HME/RT needs.

Computerized Resource Proficiency

Be proficient in the use of computerized resources and data entry programs, including OnBase, Fastrack, Carenet, ERMA, and Care Connection.

Daily Update and Reporting

Complete daily updates by running the Confirmed Orders for Billing Report to identify and correct errors in order entry.

Additional Responsibilities
  • Direct Bill Entry

Enter charges for supply closet items dispensed at off-site Advocate locations.

Insurance Eligibility Check

Check insurance eligibility for payers that allow it (BCBS, Medicare, Medicaid, HMOI).

Monthly Bulk Billing

Complete monthly bulk billing to hospital cost centers for Direct Bill items not billed to insurance due to payer being out-of-network with AHCP.

Open Orders Report

Investigate and resolve open orders, confirming or deleting them as necessary.

Patient Record Retention and Archive

Complete daily patient record retention and archive processes, preparing documents for scanning and indexing into the electronic medical record.

Reports and Data Analysis

Prepare and work various reports to maintain accurate account information and status.

Customer Service Support

Provide customer service support to internal and external customers, resolving delivery, equipment, documentation, and reimbursement issues.

Requirements
  • Education

High School Diploma

Experience

3-4 years of office experience

Knowledge and Skills

Understanding of third-party payors, including Medicare, Medicaid, and private insurance companies

Preferred Qualifications

Knowledge of medical terminology and home care experience