Patient Services Representative, PRN, Days

Prisma Health • Simpsonville, SC

1d • 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. It also includes posting all payments, balancing computer reports at day end, and requires a high level of public contact and excellent interpersonal skills. The position arranges for patient pre-payments and enforces financial agreements prior to providing service. Responsibilities include gathering charge information, coding, entering into the database, completing the billing process, and distributing billing information. The role also involves filing insurance claims, assisting patients with insurance forms, and processing unpaid accounts by contacting patients and third-party payers. This position acts as a liaison between the patient and medical support staff, greets patients and visitors courteously, checks in patients, verifies and updates insurance information, and obtains necessary signatures. The Patient Services Representative maintains the appointment book, follows office scheduling policies, provides front office phone support, and screens visitors. They are responsible for gathering, accurately coding, and posting outpatient charges, processing vouchers and private payments, and researching address verification. The role assists with processing mail, statements, and acquiring billing information. Cashiering functions, including monitoring and balancing the cash drawer, preparing daily cash deposits, and receiving payments are also key duties. The position codes and posts payments, maintains records, and works with patients on prepayment sources or financial agreements. It involves participating with other staff to achieve account resolution, assisting with outpatient coding and error resolution, and processing edits and customer service requests within specified time frames. Identifying trends and communicating problems to management, updating patient account databases, and maintaining physician schedules are also part of the role. Scheduling surgeries, ancillary services, and follow-up appointments, answering questions about appointments and testing, and assembling patient charts are included. The role updates patient profiles, oversees the waiting area, coordinates patient movement, and reports irregularities. Assistance is provided with insurance claims, disability benefits, home health care, and medical equipment. Processing benefit correspondence, signature, and insurance forms to expedite payment, and assisting patients with hospitalization or surgical pre-certification are required. Following up with insurance companies to ensure coverage approval, posting actions, and maintaining patient account records are essential. Answering patient questions about their accounts, confirming workers’ compensation claims, and preparing disability claims are also duties. The position follows up with insurance companies to ensure claims are paid, maintains files with referral slips, medical authorizations, and insurance slips, and researches information for outpatient billing. Coding procedure and diagnosis information, entering charge information, and processing/distributing billings are required. Pulling charts, delivering, transporting, sorting, and filing charts, picking up lab reports, dictations, X-rays, and correspondence are part of the role. Maintaining orderly files, filing medical reports, purging obsolete records, and destroying outdated records are necessary. Making new patient charts, repairing damaged charts, and assisting in locating and filing records are included. The role works with medical assistants and other staff to route charts and follows medical records policies. Collecting payments at time of service, reviewing accounts for timely payment, performing collection actions, and evaluating patient financial status are key. Establishing budget payment plans, recommending accounts for collection agencies, and resolving patient billing complaints are also responsibilities. The position participates with other staff to follow up on accounts until zero balance or turned over for collection, and participates in educational activities. Gathering and verifying superbills, entering charge and payment information, verifying accuracy, and printing daily reports are required. Backing up and closing computer files daily, registering new patients, updating financial information, and maintaining strict confidentiality are essential. The role performs related work as required and is expected to maintain a neat and professional appearance, demonstrate commitment to serve, and uphold 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

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.
• Arranges for patient pre-payments and enforces financial agreements prior to providing service.
• 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.
• Research address verification as needed.
• 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.
• Participates with other staff to achieve account resolution.
• 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.
• Assists with outpatient coding and error resolution.
• 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.
• Participates in educational activities.
• 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.

What This Job Offers

• Career Level: Entry Level
• Education Level: High school or GED