Patient Services Representative, Gastroenterology, FT, Days

Prisma Health•Columbia, SC

1d•Onsite

About The Position

Responsible for aspects of front office management and operation as assigned. This role involves complete and accurate patient registration, pre-certification, charge capture, and accurately coding diagnoses given by physicians. The representative will also be responsible for posting all payments and balancing computer reports at day end, requiring a high level of public contact and excellent interpersonal skills. They will arrange for patient pre-payments and enforce financial agreements prior to providing service, gather charge information, code, enter into the database, complete the billing process, and distribute billing information. Additionally, the role includes filing insurance claims, assisting patients with insurance forms, processing unpaid accounts by contacting patients and third-party payers, and serving as a liaison between patients and medical support staff. Responsibilities extend to greeting patients and visitors, checking in patients, verifying and updating insurance information, obtaining necessary signatures, assisting patients with ambulatory difficulties, maintaining the appointment book, providing front office phone support, screening visitors, and gathering/coding/posting outpatient charges. The role also involves processing vouchers and private payments, researching address verification, processing mail return statements, acquiring billing information, performing cashiering functions, preparing daily cash deposits, receiving payments, coding and posting payments, working with patients on financial agreements, participating in account resolution, assisting with outpatient coding and error resolution, processing edits and customer service requests, identifying trends, updating patient account databases, maintaining physician schedules, scheduling appointments and admissions, answering patient questions, assembling patient charts, overseeing the waiting area, assisting with insurance claims and benefits, processing benefit correspondence, assisting with pre-certification, following up with insurance companies, posting actions, answering account inquiries, confirming workers’ compensation claims, preparing disability claims, following up on claims, maintaining files, researching billing information, coding procedures and diagnoses, keying charge information, processing and distributing billings, pulling and filing charts, picking up medical reports and correspondence, checking for misfiled charts, maintaining orderly files, filing medical reports, purging obsolete records, destroying outdated records, making new patient charts, repairing damaged charts, assisting in locating and filing records, routing patient charts, and following medical records policies and procedures. The representative will collect payments at time of service, review accounts for timely payment, perform collection actions, evaluate patient financial status, establish payment plans, recommend accounts for collection agencies, identify and resolve billing complaints, and follow up on accounts until zero balance. They will also participate in educational activities, gather and verify superbills, enter charge and payment information, print and balance daily reports, back up and close computer files, register new patients, update financial information, maintain confidentiality, and perform related duties as assigned. As a representative of Prisma Health Clinical Department, maintaining a neat and professional appearance, demonstrating commitment to serve, and upholding office manual guidelines are expected.

Requirements

High school diploma or equivalent OR Post-high school diploma.
No previous experience required.
Basic understanding of ICD-9 and CPT coding preferred.
Current Prisma Health team members with 1 year of Prisma Health experience in this job profile will be accepted in lieu of education requirements.

Nice To Haves

Associate degree in technical specialty program of 18 months minimum in length preferred.
Multi-specialty group practice setting experience preferred.

Responsibilities

Complete and accurate patient registration, pre-certification, charge capture, and diagnosis coding.
Post all payments and balance computer reports at day end.
Arrange for patient pre-payments and enforce financial agreements.
Gather charge information, code, enter into database, complete billing process, and distribute billing information.
File insurance claims and assist patients with insurance forms.
Process unpaid accounts by contacting patients and third-party payers.
Serve as a liaison between patients and medical support staff.
Greet patients and visitors, check in patients, verify and update insurance information, and obtain necessary signatures.
Assist patients with ambulatory difficulties.
Maintain appointment book and follow office scheduling policies.
Provide front office phone support and screen visitors.
Gather, accurately code, and post outpatient charges.
Process vouchers and private payments, and update registration screens.
Research address verification as needed.
Process mail return statements and outgoing statements.
Acquire billing information for all doctors for all patients.
Perform cashiering functions, including monitoring and balancing cash drawer daily.
Prepare daily cash deposits.
Receive payments from patients and issue receipts.
Code and post payments and maintain required records, reports, and files.
Work with patients in securing prepayment sources or financial agreements.
Participate with other staff to achieve account resolution.
Assist with outpatient coding and error resolution.
Process edits and Customer Service and Collection Requests.
Identify trends and communicate problems to management.
Update patient account database.
Maintain and update current information on physician’s schedules.
Schedule surgeries, ancillary services, and follow-up outpatient appointments and admissions.
Answer questions regarding patient appointments and testing.
Assemble patients’ charts for next day visit.
Update profiles on all patients, ensuring completeness and accuracy.
Oversee waiting area, coordinate patient movement, and report problems or irregularities.
Assist patients with questions on insurance claims, obtaining disability insurance benefits, home health care, medical equipment, surgical care, etc.
Process benefit correspondence, signature, and insurance forms to expedite payment of outstanding claims.
Assist patients in completing all necessary forms to obtain hospitalization or Surgical pre-certification from insurance companies.
Follow-up with insurance companies ensuring that coverage is approved.
Post all actions and maintain permanent record of patient accounts.
Answer patient questions and inquiries regarding their accounts.
Confirm all workers’ compensation claims with employees.
Prepare disability claims in a timely manner.
Follow-up with insurance companies ensuring that claims are paid as directed.
Maintain files with referral slips, medical authorizations, and insurance slips.
Research all information needed to complete outpatient billing process including getting charge information from physicians.
Code information about procedures performed and diagnosis on charge.
Key charge information into on-line entry program.
Process and distribute copies of billings according to clinic policies.
Pull charts for scheduled appointments in advance.
Deliver, transport, sort, and file returned charts.
Pick up lab reports, dictations, X-rays, and correspondence.
Continually check for misfiled charts and refile according to filing system.
Maintain orderly files.
File all medical reports.
Purge obsolete records and files in storage.
Destroy outdated records following established procedures for retention and destruction.
Make up new patient charts.
Repair damaged charts.
Assist in locating and filing records.
Work with medical assistants and other staff to route patient charts to proper location.
Follow medical records policies and procedures.
Collect payments at time of service for daily outpatient visit services.
Review each account via computer to ensure patient’s account(s) are being paid on a timely basis.
Perform collection actions including contacting patients by telephone and resubmitting claims to third party reimburses.
Evaluate patient financial status and establish budget payment plans.
Review accounts for possible assignment to collection agency, make recommendation to Clinical Dept. Practice Manager.
Identify and resolve patient billing complaints.
Participate with other staff to follow up on accounts until zero balance or turned over for collection.
Participate in educational activities.
Gather and verify superbills for specified practice on a daily basis.
Enter all charge and same day payment information for patient visits and hospital patients, verifying accuracy of coding, charging and patient insurance status.
Print daily reports, verifying charge entry balancing at day end.
Back up and close computer files on a daily basis, logging as appropriate.
Register new patients after verifying patient status on computer inquiry.
Update financial information as indicated.
Maintain strictest confidentiality.
Perform other duties as assigned.
Maintain neat and professional appearance.
Demonstrate commitment to serve at all times.
Uphold guidelines set forth in office manual.