Patient Services Representative F/T Day

Prisma Health•Easley, SC

6h•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. This position requires a high level of public contact and excellent interpersonal skills. The role involves arranging for patient pre-payments and enforcing financial agreements prior to providing service. It also includes gathering charge information, coding, entering into the database, completing the billing process, and distributing billing information. The representative will file insurance claims, assist patients in completing insurance forms, and process unpaid accounts by contacting patients and third-party payers. This role serves as a liaison between the patient and medical support staff, greeting patients and visitors courteously, checking patients in, verifying and updating necessary insurance information, and obtaining required signatures. The representative will assist patients with ambulatory difficulties, maintain the appointment book, and follow office scheduling policies. They will provide front office phone support as needed, screen visitors, and respond to routine requests for information. Responsibilities also include 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 including monitoring and balancing the cash drawer daily, preparing daily cash deposits, and receiving payments from patients while issuing receipts. The representative will code and post payments, maintain required records, reports, and files, and work with patients in securing prepayment sources or financial agreements. They will participate with other staff to achieve account resolution, assist with outpatient coding and error resolution, and process edits and Customer Service and Collection Requests within specified time frames. Identifying trends and communicating problems to management, updating the patient account database, and maintaining and updating current information on physician’s schedules are also key duties. The representative will schedule surgeries, ancillary services, and follow-up outpatient appointments and admissions, answer questions regarding patient appointments and testing, and assemble patients’ charts for the next day’s visit. Updating patient profiles for completeness and accuracy, overseeing the waiting area, coordinating patient movement, and reporting problems or irregularities are part of the role. The representative will assist patients with questions on insurance claims, obtaining disability insurance benefits, home health care, medical equipment, and surgical care. They will process benefit correspondence, signatures, and insurance forms to expedite payment of outstanding claims and assist patients in completing necessary forms for hospitalization or surgical pre-certification. Following up with insurance companies to ensure coverage approval, posting all actions, and maintaining a permanent record of patient accounts are essential. Answering patient questions and inquiries regarding their accounts, confirming workers’ compensation claims, and preparing disability claims in a timely manner are also required. The representative will follow up with insurance companies to ensure claims are paid as directed and maintain files with referral slips, medical authorizations, and insurance slips. Researching information needed to complete the outpatient billing process, including getting charge information from physicians, coding procedure and diagnosis information on charges, and keying charge information into an on-line entry program are crucial. Processing and distributing copies of billings according to clinic policies, assisting with outpatient coding and error resolution, and pulling charts for scheduled appointments in advance are also part of the responsibilities. Delivering, transporting, sorting, and filing returned charts, picking up lab reports, dictations, X-rays, and correspondence, and continually checking for misfiled charts and refiling them are necessary. Maintaining orderly files, filing all medical reports, purging obsolete records and files in storage, and destroying outdated records following established procedures are also required. The representative will make up new patient charts, repair damaged charts, and assist in locating and filing records. Working with medical assistants and other staff to route patient charts to the proper location and following medical records policies and procedures are essential. The role includes collecting payments at the time of service for daily outpatient visit services, reviewing each account via computer to ensure timely payments, and performing collection actions including contacting patients by telephone and resubmitting claims. Evaluating patient financial status and establishing budget payment plans, reviewing accounts for possible assignment to a collection agency, and making recommendations to the Clinical Dept. Practice Manager are also key duties. Identifying and resolving patient billing complaints and participating with other staff to follow up on accounts until zero balance or turned over for collection are required. The representative will participate in educational activities, gather and verify superbills for the specified practice daily, and enter 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 daily, and logging as appropriate (i.e., closing all batches in accordance with policy) are also part of the role. Registering new patients after verifying patient status on computer inquiry, updating financial information as indicated, and maintaining strictest confidentiality are essential. The representative will perform other duties as assigned and is expected to maintain a neat and professional appearance, demonstrate commitment to serve at all times, and uphold guidelines set forth in the office manual.

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

Complete and accurate patient registration, pre-certification, charge capture, and accurately coding diagnoses given by physicians.
Posting all payments and balancing computer reports at day end.
Arranging for patient pre-payments and enforcing financial agreements prior to providing service.
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, checking patients in, verifying and updating insurance information, and obtaining signatures.
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.
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 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 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 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, makes 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 (i.e. closing all batches in accordance with policy).
Registering new patients after verifying patient status on computer inquiry.
Updating financial information as indicated.
Maintaining strictest confidentiality.
Performing other duties as assigned.
Maintaining neat and professional appearance, demonstrating commitment to serve at all times and upholding guidelines set forth in office manual.