Patient Services Representative, Pediatric Endocrinology, FT, Days

Prisma Health•Richland, WA

8h•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 is responsible for complete and accurate patient registration, pre-certification, charge capture, and accurately coding diagnoses given by physicians. They are also responsible for posting all payments and balancing with computer reports at day end, gathering charge information, coding, entering into the database, completing the billing process, and distributing billing information. This role acts as a liaison between the patient and medical support staff, greeting patients and visitors, checking them in, verifying and updating insurance information, and obtaining necessary signatures. The representative will maintain the appointment book, provide front office phone support, screen visitors, and respond to routine requests for information. They will also be responsible for gathering, accurately coding, and posting outpatient charges, processing vouchers and private payments, researching address verification, and helping to process mail return statements and outgoing statements. The role involves acquiring billing information for all doctors for all patients seen in practice, performing cashiering functions, preparing daily cash deposits, receiving payments, and coding and posting payments. They will work with patients to secure prepayment sources or financial agreements, assist with outpatient coding and error resolution, process edits and customer service requests, identify trends, and communicate problems to management. Updating the patient account database, maintaining physician schedules, scheduling surgeries and appointments, answering questions regarding appointments and testing, and assembling patient charts are also key duties. The representative will assist patients with questions on insurance claims, disability benefits, home health care, medical equipment, and surgical care, process benefit correspondence, and assist patients in completing forms for hospitalization or surgical pre-certification. They will follow up with insurance companies to ensure coverage approval, post all actions, and maintain permanent records of patient accounts. Answering patient questions regarding their accounts, confirming workers’ compensation claims, preparing disability claims, and following up with insurance companies to ensure claims are paid are also part of the role. Maintaining files with referral slips, medical authorizations, and insurance slips, researching information for outpatient billing, coding procedures and diagnoses, and keying charge information into an online entry program are essential. The representative will process and distribute billings, pull charts for scheduled appointments, deliver, transport, sort, and file returned charts, pick up lab reports, dictations, X-rays, and correspondence. They will continually check for misfiled charts, maintain orderly files, file all medical reports, purge obsolete records, and destroy outdated records. Making new patient charts, repairing damaged charts, assisting in locating and filing records, and working with medical assistants to route patient charts are also responsibilities. The role involves collecting payments at the time of service, reviewing accounts for timely payments, performing collection actions, evaluating patient financial status, establishing payment plans, and making recommendations for collection agencies. Identifying and resolving patient billing complaints and following up on accounts until zero balance are also required. The representative will participate in educational activities, gather and verify superbills, enter charge and payment information, verify accuracy of coding, charging, and insurance status, print and verify daily reports, and back up and close computer files daily. Registering new patients, updating financial information, maintaining confidentiality, and performing related work are also part of the duties. 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. Performs other duties as assigned.

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

Responsibilities

Responsible for complete and accurate patient registration, pre-certification, charge capture and accurately coding diagnoses given by physicians.
Responsible for posting all payments and balancing with the computer reports at day end.
Gathers charge information, codes, enters into database, completes billing process, distributes billing information.
Files insurance claims and assists patients in completing insurance forms.
Processes unpaid accounts by contacting patients and third-party payers.
Greets patients and visitors in a prompt, courteous, and helpful manner.
Checks in patients, verifies and updates necessary insurance information in the patient accounting system.
Obtains signatures on all forms and documents as required.
Maintains appointment book and follows office scheduling policies.
Provides front office phone support as needed and outlined through cross training program.
Screens visitors and responds to routine requests for information.
Responsible for gathering, accurately coding and posting outpatient charges.
Processes vouchers and private payments, to include updating registration screens based on information on checks.
Helps to process mail return statements and outgoing statements.
Acquires billing information for all doctors for all patients seen in practice.
Performs cashiering functions including monitoring and balancing cash drawer daily.
Prepares daily cash deposits.
Receives payments from patients and issues receipts.
Codes and posts payments and maintains required records, reports and files.
Works with patients in securing prepayment sources or financial agreements prior to providing service.
Assists with outpatient coding and error resolution.
Processes edits and Customer Service and Collection Request for resolution within specified time frames.
Identify trends and communicates problems to management.
Updates patient account database.
Maintains and updates current information on physician’s schedules.
Schedules surgeries, ancillary services and follow-up outpatient appointments and admissions as requested.
Answers questions regarding patient appointments and testing.
Assembles patients’ charts for next day visit.
Updates profiles on all patients, ensuring completeness and accuracy.
Oversees waiting area, coordinates patient movement, reports problems or irregularities.
Assists patients with questions on insurance claims, obtaining disability insurance benefits, home health care, medical equipment, surgical care, etc.
Processes benefit correspondence, signature, and insurance forms to expedite payment of outstanding claims.
Assists patients in completing all necessary forms to obtain hospitalization or Surgical pre-certification from insurance companies.
Follows-up with insurance companies ensuring that coverage is approved.
Posts all actions and maintains permanent record of patient accounts.
Answers patient questions and inquiries regarding their accounts.
Confirms all workers’ compensation claims with employees.
Prepares disability claims in a timely manner.
Follows-up with insurance companies ensuring that claims are paid as directed.
Maintains files with referral slips, medical authorizations, and insurance slips.
Researches all information needed to complete outpatient billing process including getting charge information from physicians.
Codes information about procedures performed and diagnosis on charge.
Keys charge information into on-line entry program.
Processes and distributes copies of billings according to clinic policies.
Pulls charts for scheduled appointments in advance.
Delivers, transports, sorts and files returned charts.
Picks up lab reports, dictations, X-rays, and correspondence.
Continually checks for misfiled charts and refiles according to filing system.
Maintains orderly files.
Files all medical reports.
Purges obsolete records and files in storage.
Destroys outdated records following established procedures for retention and destruction.
Makes up new patient charts.
Repairs damaged charts.
Assists in locating and filing records.
Works with medical assistants and other staff to route patient charts to proper location.
Follows medical records policies and procedures.
Collects payments at time of service for daily outpatient visit services.
Reviews each account via computer to ensure patient’s account(s) are being paid on a timely basis.
Performs collection actions including contacting patients by telephone and resubmitting claims to third party reimburses.
Evaluates patient financial status and establishes budget payment plans.
Reviews accounts for possible assignment to collection agency, makes recommendation to Clinical Dept. Practice Manager.
Identifies and resolves patient billing complaints.
Participates with other staff to follow up on accounts until zero balance or turned over for collection.
Gathers and verifies superbills for specified practice on a daily basis.
Enters all charge and same day payment information for patient visits and hospital patients, verifying accuracy of coding, charging and patient insurance status.
Prints daily reports, verifying charge entry balancing at day end.
Backs up and closes computer files on a daily basis, logging as appropriate (i.e. closing all batches in accordance with policy).
Registers new patients after verifying patient status on computer inquiry.
Updates financial information as indicated.
Maintains strictest confidentiality.
Participates in educational activities.
Performs related work as required.
As representative of Prisma Health Clinical Department, is expected to maintain neat and professional appearance, demonstrate commitment to serve at all times and uphold guidelines set forth in office manual.
Performs other duties as assigned.