Patient Services Representative, Orthopedics-Patewood, FT, Days

Prisma Health•Greenville, SC

About The Position

Responsible for assigned aspects of front office management and operation in an orthopedic practice. The role supports patient registration, scheduling, billing, payment processing, insurance verification and claims, medical records, and coordination between patients and medical support staff. It requires frequent public contact, strong interpersonal skills, accuracy, confidentiality, and a professional, service-oriented approach. The representative greets and assists patients and visitors; checks in patients; verifies and updates registration and insurance information; obtains required signatures; maintains appointment schedules; coordinates appointments, surgeries, ancillary services, and admissions; and helps manage patient flow and the waiting area. The position also supports phone coverage, answers questions about appointments, testing, accounts, and insurance, and assists patients with forms, pre-certification, benefits, and financial arrangements. Billing and cashiering duties include gathering and coding charges and diagnoses, entering charges and payments, posting payments, balancing daily reports and cash, preparing deposits, issuing receipts, processing claims and billing documents, and following up with patients and third-party payers on unpaid accounts. The representative helps resolve billing errors and complaints, monitors accounts, supports payment plans and collection follow-up, and maintains accurate patient account records. The role also prepares, routes, files, repairs, and maintains patient charts and medical records; gathers records and reports for appointments; and follows records retention, confidentiality, and destruction procedures. The representative participates in educational activities, follows office policies, and performs other duties as assigned.

Requirements

High school diploma or equivalent, or a post-high-school diploma.
No previous experience required.
In lieu of the education requirements, current Prisma Health team members with one year of Prisma Health experience in this job profile will be accepted.

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

Complete accurate patient registration, pre-certification, charge capture, diagnosis coding, and updates to patient account information.
Greet and assist patients and visitors, check in patients, verify insurance information, obtain required signatures, and help patients with ambulatory difficulties.
Maintain appointment schedules and physician schedule information; schedule surgeries, ancillary services, follow-up visits, and admissions as requested.
Provide front-office phone support, screen visitors, answer routine questions, and coordinate communication between patients and medical support staff.
Arrange patient prepayments and financial agreements before services; explain account matters and assist with insurance, disability, home health, equipment, and surgical-care forms and benefits.
Gather, code, enter, and distribute outpatient billing and charge information; process vouchers, claims, billing edits, and requests for account resolution.
Collect patient payments, post payments, issue receipts, balance cash and computer reports, prepare daily deposits, and maintain required records.
Contact patients and third-party payers regarding unpaid accounts, resubmit claims, support payment plans, resolve billing complaints, and follow accounts through resolution or collection referral.
Verify workers’ compensation claims, prepare disability claims, and follow up with insurers to confirm coverage and payment.
Assemble charts for upcoming visits; deliver, sort, file, locate, repair, and maintain charts and medical records; gather lab reports, dictations, X-rays, and correspondence.
Maintain orderly files, purge and destroy outdated records according to established procedures, and route charts to the appropriate staff.
Review accounts and superbills, enter same-day charges and payments, verify coding and insurance status, print and balance daily reports, and close computer batches in accordance with policy.
Identify trends and communicate problems to management while maintaining confidentiality and a neat, professional appearance.
Participate in educational activities and perform other duties as assigned.