Patient Services Rep

Prisma Health•Sumter, SC

9d•Onsite

About The Position

Responsible for assigned aspects of front-office management and operation at Sumter OB. The role supports patient registration, scheduling, billing, payment processing, insurance claims and pre-certification, account resolution, and medical-records handling. It serves as a liaison between patients and medical support staff and requires frequent public contact, strong interpersonal skills, confidentiality, and a neat, professional appearance. Team members are expected to understand and comply with Prisma Health’s purpose: “Inspire health. Serve with compassion. Be the difference.”

Requirements

High school diploma or equivalent, or a post-high-school diploma.
No previous experience required.
Basic understanding of ICD-9 and CPT coding preferred.
Ability to maintain confidentiality and provide professional, courteous service in a role with frequent public contact.

Nice To Haves

Associate degree in a technical specialty program at least 18 months in length.
Experience in a multi-specialty group practice setting.
Basic understanding of ICD-9 and CPT coding.

Responsibilities

Register patients accurately, verify and update insurance and financial information, obtain required signatures, and maintain patient account records.
Greet and assist patients and visitors, answer routine questions, provide front-office phone support, and help patients with ambulatory difficulties.
Maintain appointment books and physician schedules; schedule surgeries, ancillary services, follow-up appointments, and admissions as requested; answer questions about appointments and testing.
Gather, code, enter, and post charges and diagnoses; complete outpatient billing processes, distribute billing information, and assist with coding and error resolution.
Process payments, vouchers, and private payments; issue receipts, balance the cash drawer and daily computer reports, prepare cash deposits, and close and back up computer files according to policy.
Arrange prepayments and financial agreements; assist patients with financial arrangements and payment plans; follow up on accounts, contact patients and third-party payers, resubmit claims, and help resolve billing complaints.
File insurance claims and help patients complete insurance, disability, hospitalization, surgical pre-certification, and other benefit forms; follow up with insurers regarding coverage and payment.
Process edits and customer-service and collection requests within specified time frames; review accounts for possible collection-agency referral and make recommendations to the Clinical Department Practice Manager.
Maintain patient charts and medical records, including pulling and assembling charts, routing and filing returned charts and medical reports, repairing damaged charts, purging and destroying records under established procedures, and locating records as needed.
Gather and verify superbills, charge information, referral slips, medical authorizations, and insurance slips; research address information and process returned and outgoing statements.
Oversee the waiting area, coordinate patient movement, screen visitors, and report problems or irregularities.
Identify trends and communicate problems to management; participate with other staff to achieve account resolution and participate in educational activities.
Maintain strict confidentiality, follow office and medical-records policies, and uphold professional appearance and service expectations.
Perform other duties as assigned.