Patient Services Representative, Palmetto Family Medicine, PT, Days

Prisma Health•Greer, SC

12d•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 position requires a high level of public contact and excellent interpersonal skills, including arranging for patient pre-payments and enforcing financial agreements. Responsibilities include gathering charge information, coding, entering data, completing the billing process, filing insurance claims, assisting patients with forms, and processing unpaid accounts. The role serves as a liaison between patients and medical support staff, greeting patients, checking them in, verifying insurance information, and obtaining necessary signatures. The Patient Services Representative also maintains the appointment book, provides phone support, screens visitors, and handles outpatient charge processing and payment posting. Additional duties include cashiering, preparing deposits, researching address verification, processing mail, and working with patients on financial agreements and account resolution. The role also involves assisting with outpatient coding, processing edits, identifying trends, updating patient databases and schedules, and assembling patient charts. The representative will answer patient questions regarding appointments, testing, insurance claims, disability benefits, home health care, and medical equipment. They will also process benefit correspondence, signature, and insurance forms, and assist with obtaining pre-certification. Following up with insurance companies to ensure coverage approval and claim payment is crucial. The role requires maintaining files, researching billing information, coding procedures and diagnoses, and entering charge information into the system. Chart management, including pulling, delivering, transporting, sorting, filing, and purging records, is also a key responsibility. The representative will work with medical assistants and other staff to route charts and follow medical records policies. Collecting payments at time of service, reviewing accounts for timely payment, performing collection actions, evaluating financial status, establishing payment plans, and recommending accounts for collection agencies are also part of the role. Identifying and resolving patient billing complaints and participating in educational activities are expected. The role requires maintaining a neat and professional appearance, demonstrating commitment to service, and upholding office manual 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 accurately coding 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, to include updating registration screens.
Researching address verification as needed.
Helping to process 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 prior to providing service.
Participating with other staff to achieve account resolution.
Assisting with outpatient coding and error resolution.
Processing edits and Customer Service and Collection Request 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 as requested.
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.
Assisting with outpatient coding and error resolution.
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 other duties as assigned.