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 will also handle posting all payments, balancing computer reports at day end, arranging for patient pre-payments, and enforcing financial agreements prior to providing service. The role involves gathering charge information, coding, entering into a database, completing the billing process, and distributing billing information. Additionally, they will file insurance claims, assist patients with insurance forms, and process unpaid accounts by contacting patients and third-party payers. This position serves as a liaison between the patient and medical support staff, greeting patients courteously, checking them in, verifying and updating insurance information, and obtaining necessary signatures. Responsibilities extend to maintaining the appointment book, providing front office phone support, screening visitors, and gathering/coding outpatient charges. Cashiering functions, including monitoring and balancing the cash drawer, preparing daily deposits, and receiving payments, are also key duties. The role involves working with patients to secure prepayment sources or financial agreements, assisting with outpatient coding and error resolution, and processing edits and customer service requests. Identifying trends and communicating problems to management, updating patient account databases, and maintaining physician schedules are also part of the job. Scheduling surgeries, ancillary services, and follow-up appointments, answering patient questions about appointments and testing, and assembling patient charts are also required. The representative will update patient profiles, oversee the waiting area, coordinate patient movement, and assist patients with various inquiries regarding insurance claims, disability benefits, home health care, and medical equipment. Processing benefit correspondence, signature, and insurance forms, and assisting patients in completing forms for hospitalization or surgical pre-certification are also included. Following up with insurance companies to ensure coverage approval, posting all actions, and maintaining permanent records of patient accounts are essential. Answering patient questions about their accounts, confirming workers’ compensation claims, and preparing disability claims are also part of the role. Maintaining files with referral slips, medical authorizations, and insurance slips, and researching information for outpatient billing are necessary. The role involves coding and keying charge information into an online entry program, processing and distributing billings, and pulling/filing charts. Picking up lab reports, dictations, X-rays, and correspondence, checking for misfiled charts, maintaining orderly files, filing medical reports, purging obsolete records, and destroying outdated records are also duties. Making new patient charts, repairing damaged charts, and assisting in locating and filing records are required. Working with medical assistants and other staff to route patient charts and following medical records policies and procedures are essential. Collecting payments at time of service, reviewing accounts for timely payments, performing collection actions, evaluating patient financial status, establishing payment plans, and recommending accounts for collection agencies are also key responsibilities. Identifying and resolving patient billing complaints and participating in educational activities are also part of the role. Gathering and verifying superbills, entering charge and payment information, verifying accuracy of coding, charging, and insurance status, printing and verifying daily reports, and backing up and closing computer files are daily tasks. Registering new patients, updating financial information, and maintaining strict confidentiality are also required. 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.
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Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED