Patient Service Representative

4 weeks ago

Gurnee, Illinois, United States Advocate Health Full time

Job Summary:

The Patient Service Representative will be responsible for providing exceptional customer service to patients, physicians, and facilities while ensuring accurate and timely processing of patient orders, billing, and documentation.

Key Responsibilities:

  • Process patient orders, including confirmations, modifications, and cancellations, to ensure accurate and timely billing and revenue recognition.
  • Review and verify all paperwork submitted with equipment set up packets to ensure completeness, accuracy, and compliance with regulatory requirements.
  • Investigate and resolve any safety issues documented by drivers, including patient smoking in the home with oxygen, incorrect storage of oxygen tanks, and other potential hazards.
  • Process service maintenance tickets and schedule future service and maintenance of rental equipment.
  • Maintain knowledge of Medicare, Medicaid, HMO, Managed Care, PHO's, and Advocate contract procedures and guidelines.
  • Verify current and appropriate authorizations for all managed care clients for supplies and purchased items.
  • Identify, investigate, and verify sources of reimbursement.
  • Be proficient in the use of computerized resources and data entry programs, including OnBase, Fastrack, Carenet, ERMA, and Care Connection.
  • Complete daily updates by running the Confirmed Orders for Billing Report to identify and correct errors in order entry.
  • Enter charges through Direct Billing entry and 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.
  • Work weekly Open Orders Report and investigate reason for delay in confirmation and revenue not being collected according to pre-defined process.
  • Confirm or delete open orders after thorough investigation and confirmation that service was provided.
  • Complete daily patient record retention and archive processes, including preparing documents for scanning and indexing into the electronic medical record.
  • Operate and monitor scanning/imaging equipment and review output copies to ensure and validate continuing resolution quality of printed images.
  • Index scanned documents by accurately selecting proper patient, document type, and other descriptors.
  • Storage and destruction of scanned documents per pre-defined instructions.
  • Prepare and work various reports to maintain accurate account information and status, including monthly discharge reports and Medicare Continued Use reports.
  • Follow up on lost/stolen equipment by sending letters to patients and facilities when equipment cannot be retrieved.
  • Provide customer service support to internal and external customers by resolving delivery, equipment, documentation, and/or reimbursement issues with appropriate parties.

Requirements:

  • High School Diploma
  • 3-4 years office experience
  • Understanding of third-party payors, including Medicare, Medicaid, and private insurance companies
  • Knowledge of medical terminology preferred
  • Home care experience preferred

Skills and Abilities:

  • Strong Data Entry ability
  • Strong Organization Skills
  • Strong Detail Orientation
  • Strong Customer Service Skills
  • Able to work independently with minimal supervision

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.

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