Patient Services Representative, Pelham Family Medicine, FT, Days

Prisma Health•Greenville, SC

3d•Onsite

About The Position

Responsible for assigned aspects of front office management and operation at Pelham Family Medicine. The representative supports patient registration, scheduling, billing, payment processing, insurance and pre-certification workflows, medical records, and communication between patients and medical support staff. The role requires frequent public contact, strong interpersonal skills, accurate handling of patient and financial information, and strict confidentiality. The representative is expected to maintain a neat, professional appearance, demonstrate a commitment to service, follow office guidelines, participate in educational activities, and perform other duties as assigned.

Requirements

High school diploma or equivalent, or a post-high-school diploma.
No previous experience required.
Basic understanding of ICD-9 and CPT coding is preferred.

Nice To Haves

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

Responsibilities

Complete accurate patient registration, verify and update insurance and financial information, obtain required signatures, and maintain patient profiles and account records.
Greet patients and visitors courteously; check in patients, answer routine questions, provide front office phone support, and act as a liaison between patients and medical support staff.
Maintain appointment books and physician schedules; schedule surgeries, ancillary services, follow-up appointments, and admissions as requested; answer questions about appointments and testing.
Collect, code, enter, and post outpatient charges and payments; verify coding, charges, and insurance status; balance daily reports and cash drawers, prepare deposits, issue receipts, and close computer batches according to policy.
Arrange patient prepayments and financial agreements; process vouchers and private payments; review accounts, establish budget payment plans, pursue account resolution, and recommend accounts for collection agency assignment when appropriate.
Prepare, file, and follow up on insurance claims and forms, including pre-certification, disability, and workers’ compensation claims; contact patients and third-party payers regarding unpaid accounts and coverage approvals.
Gather charge and billing information from physicians, code procedures and diagnoses, enter charge data, process billing edits and customer service or collection requests, and distribute billing information.
Assist patients with billing questions and complaints, insurance claims, disability benefits, home health care, medical equipment, surgical care, and required hospitalization or surgical pre-certification forms.
Maintain medical records and files: assemble and pull charts, route and transport records, file reports, locate and repair charts, identify misfiled charts, create new charts, and purge or destroy outdated records according to policy.
Oversee the waiting area, coordinate patient movement, assist patients with ambulatory difficulties, screen visitors, and report problems or irregularities.
Gather and verify daily superbills, print reports, verify day-end charge entry balancing, back up and close computer files, and maintain required records, reports, and files.
Identify trends and communicate problems to management; participate with staff in account resolution and educational activities.
Maintain strict confidentiality and follow medical records policies, office procedures, and established guidelines.