Patient Services Representative, FT, Days

Prisma HealthColumbia, SC
Onsite

About The Position

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 acts as a liaison between patients and medical support staff, ensuring efficient and compassionate patient care from registration through billing and account resolution.

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 coding of diagnoses.
  • Posting all payments and balancing with computer reports at day end.
  • Arranging for patient pre-payments and enforcing financial agreements.
  • Gathering charge information, coding, entering into database, completing billing process, and distributing billing information.
  • Filing insurance claims and assisting patients with insurance forms.
  • Processing unpaid accounts by contacting patients and third-party payers.
  • Greeting patients and visitors in a prompt, courteous, and helpful manner.
  • Checking in patients, verifying and updating insurance information in the patient accounting system.
  • Obtaining necessary signatures on all forms and documents.
  • 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, including updating registration screens.
  • 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.
  • 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.
  • Answering questions regarding patient appointments and testing.
  • Assembling patients’ charts for next day visits.
  • Updating profiles on all patients, ensuring completeness and accuracy.
  • Overseeing waiting area, coordinating patient movement, and 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 a 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.
  • 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, making 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.
  • Registering new patients after verifying patient status on computer inquiry.
  • Updating financial information as indicated.
  • Maintaining strictest confidentiality.
  • Performing related work as required.
  • Maintaining neat and professional appearance, demonstrating commitment to serve at all times and upholding guidelines set forth in office manual.
  • Performing other duties as assigned.
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