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Advocate Aurora Health · 4 hours ago

Patient Service Representative (PSR) - Ortho

Libertyville, IL - 825 S Milwaukee Ave

Full-time

Onsite

Mid Level

$19.45/hr - $29.20/hr

3+ years exp

Advocate Aurora Health is the third-largest nonprofit, integrated health system in the United States, focusing on providing quality healthcare services. The Patient Service Representative will be responsible for completing patient order confirmations, processing service maintenance tickets, and ensuring accurate billing and documentation for orthopedic services.

Health Care

Responsibilities

Completes patient order confirmations and modifications for item changes occurring after initial order ticket printing to begin revenue recognition and billing processes

Reviews all paperwork submitted with equipment set up packets to ensure all forms are complete, signed and dated appropriately

Any safety issues documented by drivers will be followed up with appropriate correspondence to patients, physicians or management, such as patient smoking in the home with oxygen, incorrect storage of oxygen tanks, etc

Processes service maintenance tickets and resets the schedule for future service and maintenance of rental equipment

Maintain a knowledge of Medicare, Medicaid, HMO, Managed Care, PHO's and Advocate contract procedures and guidelines

Verify that current and appropriate authorizations are in place for all managed care clients for supplies and for purchased items

Identification, investigation and verification of sources of reimbursement

Be proficient in the use of computerized resources and data entry programs involving proper processing and qualifying of patients with clients with HME/RT needs. (These include, but are not limited to OnBase, Fastrack, Carenet, ERMA and Care Connection)

Completes daily update by running the Confirmed Orders for Billing Report to identify and correct errors in order entry

Completes Direct Bill entry for supply closet items dispensed at off site Advocate locations

Obtains payable diagnosis codes for item dispensed, using the Care Connection visit information, or as provided on the delivery transaction form

Reviews billing system to determine if patient has an existing account or creates a new account by entering demographic and insurance information

Completes insurance eligibility check within billing system for payers that system allows (BCBS, Medicare, Medicaid, HMOI)

Enters charges through Direct Billing entry

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

Works weekly Open Orders Report and investigates reason for delay in confirmation and revenue not being collected according to pre-defined process

Confirms or deletes open orders after thorough investigation and confirmation that service was provided

Completes daily patient record retention and archive processes

Prepares all documents received during the confirmation process for scanning and indexing into the electronic medical record of the patient's account by removing staples, repairing tears, etc. according to pre-defined instructions

Operates and monitors scanning/imaging equipment

Reviews output copies to ensure and validate continuing resolution quality of printed images, informing management or IS Department if unable to correct faulty resolution issues

Indexes scanned documents by accurately selecting proper patient, document type and other descriptors

Storage and destruction of scanned documents per pre-defined instructions

Prepares and works various reports in an effort to maintain accurate account information and status

Works monthly discharge reports to inactivate accounts with no active rentals and no activity in over one year

Works monthly Medicare Continued Use report for documentation of patients' use per Medicare guidelines

Follows up on lost/stolen equipment by sending letters to patients and facilities when equipment cannot be retrieved

Provides customer service support to both internal and external customers by resolving delivery, equipment, documentation and/or reimbursement issues with appropriate parties

Responds to customer equipment questions and refers to appropriate distribution associate and follows up to ensure resolution

Works with Intake and Distribution to answer questions concerning customer deliveries

Back up phone support for all AHCP departments, as well as assistance with walk-in patients

Other duties as assigned by manager

Runs, collects and tabulates data and submits to management selected, assigned reports such as the Daily Order Report