Patient Services Representative, Laurens Family Medicine, FT, Days

Prisma Health•Laurens, SC

About The Position

Responsible for assigned aspects of front office management and operation at Laurens Family Medicine. The role supports patient registration, scheduling, billing, payment processing, insurance and pre-certification activities, medical records, and communication between patients and medical support staff. The representative is expected to provide courteous service, maintain accurate and confidential patient account and medical information, and follow clinic policies and procedures. This non-management position reports to a supervisor, manager, director, or executive.

Requirements

High school diploma or equivalent, or post-high-school diploma.
No previous experience required.
Basic understanding of ICD-9 and CPT coding preferred.
Current Prisma Health team members with one year of Prisma Health experience in this job profile may qualify in lieu of the education requirements.

Nice To Haves

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

Responsibilities

Complete and accurately register patients, verify and update insurance and financial information, obtain required signatures, and maintain patient account records.
Perform pre-certification, charge capture, outpatient charge coding, billing entry, claim filing, payment posting, and billing distribution.
Collect patient payments, process vouchers and private payments, issue receipts, balance the cash drawer, prepare daily deposits, and complete day-end balancing and reporting.
Arrange patient prepayments and financial agreements, evaluate financial status, establish budget payment plans, and participate in account resolution and collection follow-up.
Contact patients and third-party payers about unpaid accounts, resubmit claims, follow up on coverage and claim payment, and assist with billing complaints and account inquiries.
Greet and assist patients and visitors; serve as a liaison between patients and medical support staff; screen visitors and respond to routine information requests.
Maintain appointment books and physician schedules; schedule surgeries, ancillary services, follow-up appointments, and admissions; answer appointment and testing questions.
Provide front-office telephone support and coordinate patient movement in the waiting area.
Assist patients with insurance claims, disability benefits, home health care, medical equipment, surgical care, hospitalization forms, and insurance pre-certification.
Process benefit correspondence and insurance forms, confirm workers’ compensation claims, prepare disability claims, and maintain referral and authorization files.
Gather charge information from physicians, code procedures and diagnoses, enter charges, resolve coding errors and edits, and process customer service and collection requests within required time frames.
Assemble charts for upcoming visits; create, update, repair, locate, route, file, and store medical records; retrieve and distribute reports and correspondence; and destroy outdated records according to established procedures.
Gather and verify superbills, enter charges and same-day payments, verify coding and insurance status, print daily reports, and close and back up computer files according to policy.
Identify trends and communicate problems to management; participate in educational activities; maintain confidentiality and a neat, professional appearance; perform other duties as assigned.