Patient Services Representative, Seneca Medical Associates, FT, Days

Prisma Health•Seneca, SC

About The Position

The Patient Services Representative is responsible for assigned aspects of front office management and operation at Seneca Medical Associates. The role supports patient registration, scheduling, billing, payment processing, insurance claims, medical records, and communication between patients and medical support staff. The representative is expected to provide courteous service, maintain confidentiality, follow office and medical-records procedures, and uphold Prisma Health’s purpose: “Inspire health. Serve with compassion. Be the difference.” A neat and professional appearance and a commitment to service are expected.

Requirements

High school diploma or equivalent, or a post-high-school diploma. In lieu of the education requirements, current Prisma Health team members with one year of Prisma Health experience in this job profile will be accepted.
No previous experience required.
Basic understanding of ICD-9 and CPT coding preferred.
Required certifications, registrations, and licenses: none specified.

Nice To Haves

Associate degree in a technical specialty program at least 18 months in length.
Experience in a multi-specialty group practice setting.
Basic understanding of ICD-9 and CPT coding.

Responsibilities

Register patients accurately; verify and update insurance, financial, and other patient information; obtain required signatures; and create or update patient profiles.
Greet and assist patients and visitors, answer account and appointment questions, screen visitors, provide front-office phone support, and serve as a liaison between patients and medical support staff.
Maintain appointment books and physician schedules; schedule surgeries, ancillary services, follow-up appointments, and admissions; answer questions about appointments and testing.
Gather, code, enter, and post outpatient charges and diagnoses; verify superbills, coding, insurance status, and charge-entry accuracy; process billing information and distribute billing documents.
Post payments, process vouchers and private payments, issue receipts, balance cash and computer reports, prepare deposits, and complete daily cashiering and batch-closing procedures.
Collect patient payments at the time of service; arrange prepayments and financial agreements; evaluate financial status and establish budget payment plans.
File and resubmit insurance claims; assist patients with insurance forms and claims; obtain pre-certification and authorization; follow up with insurers regarding coverage and payment; and process benefit correspondence and disability claims.
Contact patients and third-party payers about unpaid accounts, participate in account resolution, identify accounts for possible collection referral, and help resolve billing complaints.
Maintain patient account records, files, referral slips, authorizations, insurance slips, and required reports; research address information and process returned and outgoing statements.
Assemble charts for upcoming appointments; pull, transport, sort, file, locate, repair, and create charts; file medical reports; identify and correct misfiled charts; purge or destroy records according to retention procedures; and route charts with medical staff.
Coordinate patient movement and oversee the waiting area; assist patients with ambulatory difficulties and questions about insurance claims, disability benefits, home health care, medical equipment, and surgical care.
Process edits and customer service and collection requests within specified time frames; identify trends and communicate problems to management.
Maintain strict confidentiality, participate in educational activities, perform related work as required, and complete other duties as assigned.