Patient Services Representative F/T Day

Prisma Health•Greer, SC

7d•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 representative will also be responsible for posting all payments and balancing computer reports at day end. This position requires a high level of public contact and excellent interpersonal skills. The role involves arranging for patient pre-payments and enforcing financial agreements prior to providing service, gathering charge information, coding, entering into the database, completing the billing process, and distributing billing information. It also includes 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 the patient and medical support staff, greets patients and visitors courteously, checks in patients, 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 component of this role, as outlined through a cross-training program. The representative screens visitors, responds to routine information requests, and is responsible for gathering, accurately coding, and posting outpatient charges. They process vouchers and private payments, update registration screens, research address verification, and help process mail return statements and outgoing statements. The role involves acquiring billing information for all doctors for all patients seen in practice, performing cashiering functions including monitoring and balancing the cash drawer daily, and preparing daily cash deposits. They receive payments from patients, issue receipts, code and post payments, and maintain required records, reports, and files. The representative works with patients in securing prepayment sources or financial agreements, participates with other staff to achieve account resolution, and assists with outpatient coding and error resolution. They process edits and Customer Service and Collection Requests for resolution within specified time frames, identify trends, and communicate problems to management. Updating the patient account database, maintaining and updating physician’s schedules, and scheduling surgeries, ancillary services, and follow-up appointments are also key duties. The role involves answering questions regarding patient appointments and testing, assembling patient charts, updating patient profiles for completeness and accuracy, and overseeing the waiting area, coordinating patient movement, and reporting problems. Assistance is provided to patients with questions on insurance claims, disability benefits, home health care, medical equipment, and surgical care. Processing benefit correspondence, signatures, and insurance forms to expedite payment of outstanding claims, and assisting patients in completing forms for hospitalization or surgical pre-certification are included. The representative follows up with insurance companies to ensure coverage approval, posts all actions, and maintains permanent records of patient accounts. They answer patient questions regarding their accounts, confirm workers’ compensation claims, prepare disability claims, and follow up with insurance companies to ensure claims are paid. Maintaining files with referral slips, medical authorizations, and insurance slips, researching information for the outpatient billing process, and coding procedures and diagnoses are also part of the role. Keying charge information into an on-line entry program, processing and distributing billings, and assisting with outpatient coding and error resolution are required. Pulling charts for scheduled appointments, delivering, transporting, sorting, and filing returned charts, and picking up lab reports, dictations, X-rays, and correspondence are also duties. The representative continually checks for misfiled charts, refiles according to the system, maintains orderly files, files all medical reports, purges obsolete records, and destroys outdated records following established procedures. They make up new patient charts, repair damaged charts, assist in locating and filing records, and work with medical assistants and other staff to route patient charts. Following medical records policies and procedures is essential. The role includes collecting payments at the time of service, reviewing accounts for timely payment, performing collection actions including contacting patients by telephone and resubmitting claims, and evaluating patient financial status to establish budget payment plans. Recommendations are made to the Clinical Dept. Practice Manager regarding accounts for collection agencies. Identifying and resolving patient billing complaints and following up on accounts until zero balance or turned over for collection are also responsibilities. Participation in educational activities, gathering and verifying superbills, and entering charge and payment information are required, verifying accuracy of coding, charging, and patient insurance status. Printing daily reports, verifying charge entry balancing, backing up and closing computer files daily, and registering new patients after verifying status are also duties. Maintaining strictest confidentiality and performing related work as required are expected. As a representative of Prisma Health Clinical Department, maintaining a neat and professional appearance, demonstrating commitment to serve, and upholding guidelines set forth in the office manual are essential. Performs other duties as assigned.

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 accurately coding diagnoses given by physicians.
Posting all payments and balancing computer reports at day end.
Arranging for patient pre-payments and enforcing financial agreements prior to providing service.
Gathering charge information, coding, entering into database, completing billing process, and distributing billing information.
Filing insurance claims and assisting patients in completing 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 necessary insurance information in the patient accounting system.
Obtaining signatures on all forms and documents as required.
Assisting patients with ambulatory difficulties.
Maintaining appointment book and following office scheduling policies.
Providing front office phone support as needed and outlined through cross training program.
Screening visitors and responding to routine requests for information.
Gathering, accurately coding and posting outpatient charges.
Processing vouchers and private payments, to include updating registration screens based on information on checks.
Researching address verification as needed.
Helping to process 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 prior to providing service.
Participating with other staff to achieve account resolution.
Assisting with outpatient coding and error resolution.
Processing edits and Customer Service and Collection Request 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 as requested.
Answering questions regarding patient appointments and testing.
Assembling patients’ charts for next day visit.
Updating profiles on all patients, ensuring completeness and accuracy.
Overseeing waiting area, coordinating patient movement, 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 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.
Assisting with outpatient coding and error resolution.
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, makes 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 (i.e. closing all batches in accordance with policy).
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 uphold guidelines set forth in office manual.
Performing other duties as assigned.