Sr. PSR

Prism Vision Group•Westfield, NJ

About The Position

Under general supervision, the Sr. PSR performs general business office functions, which may include billing and claim submissions; charge capture and payment posting; insurance verification and eligibility; obtaining pre-authorization; counseling patients and families about insurance and payment issues; and account follow-up and payment resolution. As necessary, the role assists patients and families in obtaining community resources, including housing, transportation, and financial support. The position supports and adheres to the US Oncology Compliance Program, including its Code of Ethics and Business Standards.

Requirements

High school diploma or equivalent.
Three to five years of medical business office experience.
Requires vision and hearing corrected to normal ranges.

Responsibilities

Obtain patients’ insurance, demographic, and eligibility information and enter it accurately and promptly; register patients as necessary.
Collect and review patient insurance information and complete insurance forms.
Collect co-pays, deductibles, and other out-of-pocket amounts at the time of the visit.
Verify insurance coverage and eligibility, obtain pre-authorizations or referrals, assess financial requirements, and advise patients and families about benefits and payment obligations.
Post line items and adjustments to patient accounts; balance receipts, reconcile daily work batches, prepare audit trails, and prepare bank deposits as needed.
Review Explanation of Benefits (EOB) documents for consistency.
Submit files and process claims for payment; research and resolve claim delays.
Address patient questions and complaints about insurance billing, adjust accounts as needed, resubmit claims, process insurance and patient correspondence, and provide documentation to expedite payment.
Follow up on assigned accounts and use collection techniques to keep accounts current, including monitoring delinquent payments.
Set up financial arrangements with patients as needed.
Assist patients with researching and obtaining community resources, including housing, transportation, drugs and pharmaceutical supplies, and financial resources.
Support and adhere to the US Oncology Compliance Program, including the Code of Ethics and Business Standards.