Patient Services Representative F/T Day

Prisma Health•Greenville, SC

13d•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 position requires posting all payments, balancing computer reports at day end, and maintaining a high level of public contact with excellent interpersonal skills. The representative will arrange for patient pre-payments and enforce financial agreements before services are provided. They will gather charge information, code it, enter it into the database, complete the billing process, and distribute billing information. This role also involves filing insurance claims, assisting patients with insurance forms, and processing unpaid accounts by contacting patients and third-party payers. The Patient Services Representative acts as a liaison between patients and medical support staff, greets patients and visitors courteously, checks patients in, verifies and updates insurance information, and obtains necessary signatures. They assist patients with ambulatory difficulties, maintain the appointment book, and follow office scheduling policies. Phone support is also a responsibility, as is screening visitors and responding to routine information requests. The role includes gathering, coding, and posting outpatient charges, processing vouchers and private payments, and researching address verification. Assistance with mail return statements and outgoing statements is required, as is acquiring billing information for all doctors for all patients seen in practice. Cashiering functions, including monitoring and balancing the cash drawer daily, preparing daily cash deposits, and receiving payments with receipts, are part of the duties. Payments are coded and posted, and required records, reports, and files are maintained. Patients are assisted in securing prepayment sources or financial agreements. Participation with other staff to achieve account resolution, assisting with outpatient coding and error resolution, and processing edits and Customer Service and Collection Requests within specified time frames are also key functions. Identifying trends and communicating problems to management, updating the patient account database, and maintaining current physician schedule information are expected. Scheduling surgeries, ancillary services, and follow-up appointments/admissions, answering questions about appointments and testing, and assembling patient charts are also duties. The representative will update patient profiles for completeness and accuracy, oversee the waiting area, coordinate patient movement, and report problems. Assistance with insurance claims, disability benefits, home health care, medical equipment, and surgical care questions is provided. Processing benefit correspondence, signatures, and insurance forms to expedite claims, and assisting patients in completing forms for hospitalization or surgical pre-certification are required. Follow-up with insurance companies to ensure coverage approval, posting all actions, and maintaining permanent records of patient accounts are essential. Answering patient questions regarding their accounts, confirming workers’ compensation claims, and preparing disability claims are part of the role. Following up with insurance companies to ensure claims are paid, maintaining files with referral slips, medical authorizations, and insurance slips, and researching information for outpatient billing are necessary. Coding procedure and diagnosis information on charges, keying charge information into the on-line entry program, and processing/distributing billings are required. Pulling charts for scheduled appointments in advance, delivering, transporting, sorting, and filing returned charts, and picking up lab reports, dictations, X-rays, and correspondence are duties. Continually checking for misfiled charts, refiling, maintaining orderly files, filing medical reports, purging obsolete records, and destroying outdated records are also responsibilities. Making new patient charts, repairing damaged charts, and assisting in locating and filing records are part of the role. Collaboration with medical assistants and other staff to route patient charts and adherence to medical records policies and procedures are expected. Collecting payments at time of service, reviewing accounts for timely payment, performing collection actions including telephone contact and claim resubmission, and evaluating patient financial status to establish payment plans are key. Recommending accounts for collection agency assignment and identifying/resolving patient billing complaints are also duties. Participation in educational activities, gathering and verifying superbills, entering charge and payment information, and verifying accuracy of coding, charging, and insurance status are required. Printing daily reports, verifying charge entry balancing, backing up and closing computer files daily, and registering new patients while updating financial information are essential. Maintaining strict confidentiality and performing other related duties as assigned are expected. As a representative of Prisma Health Clinical Department, maintaining a neat and professional appearance, demonstrating commitment to serve, and upholding office manual guidelines are required.

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 diagnosis coding.
Post all payments and balance computer reports at day end.
Arrange for patient pre-payments and enforce financial agreements.
Gather charge information, code it, enter it into the database, complete the billing process, and distribute billing information.
File insurance claims and assist patients with insurance forms.
Process unpaid accounts by contacting patients and third-party payers.
Act as a liaison between patients and medical support staff.
Greet patients and visitors courteously, check them in, verify and update insurance information, and obtain necessary signatures.
Assist patients with ambulatory difficulties.
Maintain the appointment book and follow office scheduling policies.
Provide front office phone support as needed.
Screen visitors and respond to routine information requests.
Gather, accurately code, and post outpatient charges.
Process vouchers and private payments, and update registration screens.
Research address verification as needed.
Process mail return statements and outgoing statements.
Acquire billing information for all doctors for all patients seen in practice.
Perform cashiering functions including monitoring and balancing cash drawer daily.
Prepare daily cash deposits.
Receive payments from patients and issue receipts.
Code and post payments and maintain required records, reports, and files.
Work with patients in securing prepayment sources or financial agreements.
Participate with other staff to achieve account resolution.
Assist with outpatient coding and error resolution.
Process edits and Customer Service and Collection Requests for resolution within specified time frames.
Identify trends and communicate problems to management.
Update patient account database.
Maintain and update current information on physician’s schedules.
Schedule surgeries, ancillary services, and follow-up outpatient appointments and admissions.
Answer questions regarding patient appointments and testing.
Assemble patients’ charts for next day visit.
Update profiles on all patients, ensuring completeness and accuracy.
Oversee waiting area, coordinate patient movement, and report problems or irregularities.
Assist patients with questions on insurance claims, obtaining disability insurance benefits, home health care, medical equipment, surgical care, etc.
Process benefit correspondence, signature, and insurance forms to expedite payment of outstanding claims.
Assist patients in completing all necessary forms to obtain hospitalization or Surgical pre-certification from insurance companies.
Follow-up with insurance companies ensuring that coverage is approved.
Post all actions and maintain permanent record of patient accounts.
Answer patient questions and inquiries regarding their accounts.
Confirm all workers’ compensation claims with employees.
Prepare disability claims in a timely manner.
Follow-up with insurance companies ensuring that claims are paid as directed.
Maintain files with referral slips, medical authorizations, and insurance slips.
Research all information needed to complete outpatient billing process including getting charge information from physicians.
Code information about procedures performed and diagnosis on charge.
Key charge information into on-line entry program.
Process and distribute copies of billings according to clinic policies.
Assist with outpatient coding and error resolution.
Pull charts for scheduled appointments in advance.
Deliver, transport, sort, and file returned charts.
Pick up lab reports, dictations, X-rays, and correspondence.
Continually check for misfiled charts and refile according to filing system.
Maintain orderly files.
File all medical reports.
Purge obsolete records and files in storage.
Destroy outdated records following established procedures for retention and destruction.
Make up new patient charts.
Repair damaged charts.
Assist in locating and filing records.
Work with medical assistants and other staff to route patient charts to proper location.
Follow medical records policies and procedures.
Collect payments at time of service for daily outpatient visit services.
Review each account via computer to ensure patient’s account(s) are being paid on a timely basis.
Perform collection actions including contacting patients by telephone and resubmitting claims to third party reimburses.
Evaluate patient financial status and establish budget payment plans.
Review accounts for possible assignment to collection agency, make recommendation to Clinical Dept. Practice Manager.
Identify and resolve patient billing complaints.
Participate with other staff to follow up on accounts until zero balance or turned over for collection.
Participate in educational activities.
Gather and verify superbills for specified practice on a daily basis.
Enter all charge and same day payment information for patient visits and hospital patients, verifying accuracy of coding, charging and patient insurance status.
Print daily reports, verifying charge entry balancing at day end.
Back up and close computer files on a daily basis, logging as appropriate (i.e. closing all batches in accordance with policy).
Register new patients after verifying patient status on computer inquiry.
Update financial information as indicated.
Maintain strictest confidentiality.
Perform other duties as assigned.
Maintain neat and professional appearance, demonstrate commitment to serve at all times and uphold guidelines set forth in office manual.