Patient Services Representative, BEH John St, FT, Days

Prisma Health • Easley, SC

3d • Onsite

About The Position

Responsible for aspects of front office management and operation as assigned. This role requires a high level of public contact and excellent interpersonal skills. The Patient Services Representative acts as a liaison between patients and medical support staff, greeting patients and visitors, checking them in, verifying insurance information, and obtaining necessary signatures. They also assist patients with ambulatory difficulties, maintain appointment schedules, and provide front office phone support. The role involves gathering, coding, and posting outpatient charges, processing payments, and balancing the cash drawer daily. Additionally, they handle billing processes, file insurance claims, assist patients with insurance forms, and process unpaid accounts by contacting patients and third-party payers. The position also includes assembling patient charts, updating patient profiles, overseeing the waiting area, and assisting patients with various inquiries regarding insurance, benefits, and medical services. A key aspect of the role is ensuring the accuracy and completeness of patient information and financial records, maintaining strict confidentiality, and participating in educational activities. As a representative of Prisma Health Clinical Department, the individual is expected to maintain a neat and professional appearance, demonstrate a commitment to service, and uphold office guidelines.

Requirements

• High school diploma or equivalent OR Post-high school diploma.
• No previous experience required.
• Basic understanding of ICD-9 and CPT coding preferred.

Nice To Haves

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

Responsibilities

• Complete and accurate patient registration, pre-certification, charge capture, and coding of diagnoses.
• Posting all payments and balancing with computer reports at day end.
• Arranging for patient pre-payments and enforcing financial agreements.
• Gathering charge information, coding, entering into database, completing billing process, and distributing billing information.
• Filing insurance claims and assisting patients in completing insurance forms.
• Processing unpaid accounts by contacting patients and third-party payers.
• Greeting patients and visitors in a prompt, courteous, and helpful manner.
• Checking in patients, verifying and updating necessary insurance information in the patient accounting system.
• Obtaining signatures on all forms and documents as required.
• Assisting patients with ambulatory difficulties.
• Maintaining appointment book and following office scheduling policies.
• Providing front office phone support as needed.
• Screening visitors and responding to routine requests for information.
• Gathering, accurately coding, and posting outpatient charges.
• Processing vouchers and private payments, including updating registration screens.
• Researching address verification as needed.
• Processing mail return statements and outgoing statements.
• Acquiring billing information for all doctors for all patients seen in practice.
• Performing cashiering functions including monitoring and balancing cash drawer daily.
• Preparing daily cash deposits.
• Receiving payments from patients and issuing receipts.
• Coding and posting payments and maintaining required records, reports, and files.
• Working with patients in securing prepayment sources or financial agreements.
• Participating with other staff to achieve account resolution.
• Assisting with outpatient coding and error resolution.
• Processing edits and Customer Service and Collection Requests for resolution within specified time frames.
• Identifying trends and communicating problems to management.
• Updating patient account database.
• Maintaining and updating current information on physician’s schedules.
• Scheduling surgeries, ancillary services, and follow-up outpatient appointments and admissions.
• Answering questions regarding patient appointments and testing.
• Assembling patients’ charts for next day visit.
• Updating profiles on all patients, ensuring completeness and accuracy.
• Overseeing waiting area, coordinating patient movement, reporting problems or irregularities.
• Assisting patients with questions on insurance claims, obtaining disability insurance benefits, home health care, medical equipment, surgical care, etc.
• Processing benefit correspondence, signature, and insurance forms to expedite payment of outstanding claims.
• Assisting patients in completing all necessary forms to obtain hospitalization or Surgical pre-certification from insurance companies.
• Following-up with insurance companies ensuring that coverage is approved.
• Posting all actions and maintaining permanent record of patient accounts.
• Answering patient questions and inquiries regarding their accounts.
• Confirming all workers’ compensation claims with employees.
• Preparing disability claims in a timely manner.
• Following-up with insurance companies ensuring that claims are paid as directed.
• Maintaining files with referral slips, medical authorizations, and insurance slips.
• Researching all information needed to complete outpatient billing process including getting charge information from physicians.
• Coding information about procedures performed and diagnosis on charge.
• Keying charge information into on-line entry program.
• Processing and distributing copies of billings according to clinic policies.
• Pulling charts for scheduled appointments in advance.
• Delivering, transporting, sorting, and filing returned charts.
• Picking up lab reports, dictations, X-rays, and correspondence.
• Continually checking for misfiled charts and refiling according to filing system.
• Maintaining orderly files.
• Filing all medical reports.
• Purging obsolete records and files in storage.
• Destroying outdated records following established procedures for retention and destruction.
• Making up new patient charts.
• Repairing damaged charts.
• Assisting in locating and filing records.
• Working with medical assistants and other staff to route patient charts to proper location.
• Following medical records policies and procedures.
• Collecting payments at time of service for daily outpatient visit services.
• Reviewing each account via computer to ensure patient’s account(s) are being paid on a timely basis.
• Performing collection actions including contacting patients by telephone and resubmitting claims to third party reimburses.
• Evaluating patient financial status and establishing budget payment plans.
• Reviewing accounts for possible assignment to collection agency, making recommendation to Clinical Dept. Practice Manager.
• Identifying and resolving patient billing complaints.
• Participating with other staff to follow up on accounts until zero balance or turned over for collection.
• Participating in educational activities.
• Gathering and verifying superbills for specified practice on a daily basis.
• Entering all charge and same day payment information for patient visits and hospital patients, verifying accuracy of coding, charging, and patient insurance status.
• Printing daily reports, verifying charge entry balancing at day end.
• Backing up and closing computer files on a daily basis, logging as appropriate.
• Registering new patients after verifying patient status on computer inquiry.
• Updating financial information as indicated.
• Maintaining strictest confidentiality.
• Performing related work as required.
• Performing other duties as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED