Patient Service Associate - Central Carolina Surgery

Patient Service Associate - Central Carolina Surgery

We are seeking a Patient Service Associate to be an integral part of the patient care team in the clinic / service area. The Patient Service Associate is responsible for patient registration activities including patient identification, documentation of any special needs (language, mobility or other ADA identified needs), demographic and insurance updates. The PSA must ensure all financial and compliance related documents are completed and documented, check-in, check-out, point of service collections (deductible, copay, coinsurance, and balances), referral and order management, appointment coordination / scheduling, work queue management, MyChart enrollment and cash management according to established policies and procedures. The Patient Service Associate is expected to follow all regulatory and compliance policies. The Patient Service Associate is also responsible for living Duke's values and demonstrating expected behaviors while contributing to creating a positive patient experience and building a positive work environment. The Patient Service Associate will maintain a professional image in appearance and over the phone. The Patient Service Associate contributes to ensuring the registration desk and waiting areas safeguard patient privacy, confidentiality and safety and are well maintained and clean.

Job Duties and Responsibilities :

• Correctly identify patient by checking an approved photo ID and utilizing a minimum of 2 approved patient identifiers. Follow Red Flag procedure for patients unable to identify / verify.
• Verify, capture, and update demographic information to include name, address, phone number, emergency contact, guarantor, race, ethnicity, veteran status, employer, primary care provider and / or referring provider, primary language and religious preference in Maestro Care as needed. Ensure all information is complete.
• Verify, capture and update insurance information; determine and select insurance carrier, enter subscriber information, and plan information. Run RTE (Real Time Eligibility) for any updates or changes to insurance and verify benefits for reimbursement.
• Review / resolve eligibility edits, coordination of benefits, data mismatch, and content errors. Appropriately document in medical record.
• Capture and appropriately document patients with special needs, for example risk for falls, interpreter, short of stature. Communicate with clinical staff and correctly align special needs fields with any ambulatory documentation conflicts to minimize risks and meet joint commission standards.
• Present and educate patients on financial, compliance, and authorization forms and obtain all necessary signatures as required per policy. (For example, COA / COT, MSPQ, ABN, and Self-Administered Drugs.) Appropriately label, scan, and document to medical record for retention. Modify communication to ensure patient understanding if necessary.
• Identify and collect patient financial liabilities (copay, coinsurance, deductibles, account balance); post appropriately based on payment type, payment amount and method of payment.
• Explain Financial Assistance policy to patients. Complete Medicaid screening questions for self-pay patients. Direct patients to Financial Care Counselor or Customer Service as needed for further financial counseling, billing questions, payment plan set up, missing authorizations for services while protecting the patient's privacy.
• Explain billing and insurance implications for provider and hospital-based clinics to include the patient's responsibility of co-insurance and co-pay, and the potential for multiple bills. Address all questions and concerns; appropriately refer to FCC or Customer Service if PSA is unable to answer the questions.
• Provide education, generate enrollment codes and support to encourage MyChart enrollment. Identify and assign appropriate proxy process in accordance with state and federal regulations to minimize inappropriate medical record access.
• Identify need for clinical questionnaire completion and provide to patients as needed.
• Communicate wait times; set patient and provider expectations; round in waiting room to ensure a positive patient experience. Address concerns with patient; involve clinic leadership as needed.
• Coordinate prisoner arrival through communication with prisoner's guard and clinical staff to expedite check-in and rooming of patient to ensure patient safety.
• During checkout process, correctly identify patient; review After Visit Summary (AVS) for patient follow ups. Schedule return appointments; manage referrals and orders.
• Balance cash, check, and credit card collections at the end of each day; reconcile discrepancies and prepare personal deposit for cash manager according to cash management policies.
• Meet Private Card Industry (PCI) standards by securing cash and credit card receipts at all times during clinic hours, following policy for obtaining and return of cash bags on daily basis.
• Obtain Imprest cash bag at the beginning of the shift. Complete Imprest cash bag logs, void refund logs, and receipt book logs (as needed) to meet internal control standards.
• Resolve system-warning messages related to registration items (for example verification of patient coverage, review of guarantor information for billing / collections, and confirmation check list items) to ensure compliance with billing and safety regulations.
• Complete all work according to procedures and standards. Achieve registration quality expectations to meet key performance indicators related to timely billing, collections, patient experience and safety initiatives.
• Safeguard sensitive information to maintain confidentiality and in adherence to HIPAA guidelines

Scheduling :

Work Queue Management :

Patient Engagement & Work Culture / Miscellaneous Tasks :