Patient Services Representative, Pelham Family Medicine, FT, Days

Prisma Health•Greenville, SC

5d•Onsite

About The Position

The Patient Services Representative is responsible for assigned aspects of front-office management and operations at Pelham Family Medicine. The role supports patient registration, scheduling, billing, payment collection, insurance processing, medical records, and communication between patients and medical support staff. The representative is expected to provide courteous service, maintain confidentiality, follow office and records procedures, and uphold 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 is preferred.

Nice To Haves

Associate degree in a technical specialty program at least 18 months in length.
Experience in a multi-specialty group practice setting.

Responsibilities

Register patients accurately; verify and update demographic, financial, and insurance information; obtain required signatures; and update patient profiles and account records.
Greet patients and visitors courteously, check in patients, respond to routine information requests, answer appointment and testing questions, and assist patients with ambulatory difficulties.
Maintain appointment books and physician schedules; schedule surgeries, ancillary services, follow-up visits, and admissions as requested.
Provide front-office phone support as needed and screen visitors.
Gather, code, enter, and post outpatient charges and diagnoses; obtain charge information from physicians; verify coding, charges, and insurance status; and assist with coding and error resolution.
Complete billing processes, distribute billing information, file insurance claims, assist patients with insurance forms, and process billing edits and customer service or collection requests within specified time frames.
Collect and post payments, issue receipts, monitor and balance the cash drawer, prepare daily deposits, and balance daily activity against computer reports.
Arrange patient prepayments and financial agreements before services; evaluate financial status, establish payment plans, and participate in resolving accounts through payment or collection.
Contact patients and third-party payers about unpaid accounts, resubmit claims, follow up on insurance coverage and claim payments, and identify accounts for possible collection agency assignment.
Assist patients with questions and processes related to insurance claims, disability benefits, home health care, medical equipment, surgical care, and hospitalization or surgical pre-certification.
Process benefit correspondence, authorization and insurance forms, workers’ compensation claims, and disability claims; maintain referral slips, medical authorizations, and insurance slips.
Assemble charts for upcoming visits; transport, sort, file, locate, repair, and create charts; file medical reports; and maintain orderly records in accordance with medical-records policies.
Pick up lab reports, dictations, X-rays, and correspondence; route charts with medical assistants and other staff; and purge or destroy records according to retention procedures.
Gather and verify superbills, enter same-day payments and charges, print daily reports, balance charge entry, and back up and close computer files and batches in accordance with policy.
Oversee the waiting area, coordinate patient movement, report problems or irregularities, identify trends, and communicate problems to management.
Maintain neat and professional appearance, strict confidentiality, and a commitment to service; participate in educational activities and perform other duties as assigned.