Patient Service Representative I AHWFB

13348 Enterprise Revenue Cycle - Wake Forest Lexington NC Arrival Full time Yes 40 hours per week Monday through Friday from 8:30am to 5:00pm. Occasional Saturday and Monday clinic. $20.80 - $31.20 Education/Experience: High school diploma or GED required. Patient access (scheduling, registration and financial clearance), insurance verification, billing or certified medical assistant experience preferred. Reports To: Supervisor or Manager Essential Functions: 1. Greets patients arriving for their appointments. Monitors patient flow to ensure patients are cared for in the most efficient and courteous manner. 2. Ensures all patient demographic and insurance information is complete and accurate. 3. Completes the registration process on walk-in patients, verifies and/or updates patient demographic and insurance information if changes or additions have occurred. 4. 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. 5. Follows the Financial Clearance policy for non-urgent patient services if financial clearance has not been completed or authorization has not been obtained, when appropriate. 6. Identifies patients in need of financial assistance and refers patients to Financial Counselor. 7. Performs visit closure, including but not limited to checking out patients, scheduling follow-up appointment(s), collecting additional patient responsibility (when applicable) and providing patient with appropriate documents. 8. Maintains knowledge of and reference materials of the following: Medicare, Medicaid and third-party payer requirements, guidelines and policies, insurance plans requiring pre-authorization/referral and a list of current accepted insurance plans. 9. Proactively communicates issues involving customer service and process improvement opportunities to management. 10. Meets productivity requirements to ensure excellent service is provided to customers. 11. Meets or exceeds performance expectations of 98% accuracy rate and established department productivity measurements. 12. 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 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 the patient referral, pre-certification 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. 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. Our Commitment to You: Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more so you can live fully at and away from work, including: Compensation: Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training Premium pay such as shift, on call, and more based on a teammate's job Incentive pay for select positions Opportunity for annual increases based on performance Benefits and More: Paid Time Off programs Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability Flexible Spending Accounts for eligible health care and dependent care expenses Family benefits such as adoption assistance and paid parental leave Defined contribution retirement plans with employer match and other financial wellness programs Educational Assistance Program

Created: 2026-03-08