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Jobs · Healthcare · Georgia

PATIENT ACCESS SERVICES REP I, PATIENT FINANCIAL SERVS

SGMC Health · Valdosta, GA · 6 days ago
On-siteHealthcareOther

About the Role

Responsible for obtaining necessary demographic and financial data through patient interviews, the centralized scheduling system, and system queries to complete the pre-registration process. Requires verification of insurance benefits and accurate entry of patient demographic and financial data. Will fulfill managed care requirements and pre-certification needs, ensure accuracy of information entered and documentation provided, and coordinate referral of accounts to appropriate PFS personnel, including Customer Service Representatives, Billers, and Patient Account Collectors.

Responsibilities & Requirements

  • Obtain demographic and financial data via patient interviews and system queries.
  • Verify insurance benefits and enter patient demographic and financial data accurately.
  • Fulfill managed care requirements and pre-certification needs.
  • Ensure accuracy of entered information and documentation.
  • Coordinate referral of accounts to Customer Service Representatives, Billers, and Patient Account Collectors.
  • Knowledge of insurance/managed care, including Medicare, Medicaid (Georgia and Florida), Peach Care, Tricare, VA, and various managed care plans (HMO, PPO, POS, Medicare HMO).
  • Strong verbal communication skills for interactions with patients, departments, physician offices, insurance companies, and regulatory agencies.
  • Familiarity with medical terminology, CPT-4, HCPCS, ICD-9, and DRG coding.
  • Understanding of regulatory and legal requirements such as Medicare Secondary Payer Questionnaire, Advance Directives, ABNs, and coordination of benefits.
  • Knowledge of reimbursement methodologies, including percent-of-charges, DRGs, discounted fee-for-service, capitation, and per diems.
  • Thorough understanding of patient type, financial class, insurance master, employer codes, clinic codes, physician coding, and related codes.
  • Organize workload efficiently and type 40 wpm accurately.

Qualifications & Skills

  • PC and Windows literacy required.
  • Preferred knowledge or experience with HBOC Series 2000 ADT/PA, Florida Shared System, Medifax, Microsoft Office applications, and Dr. Chart.
  • College degree or coursework preferred.
  • CPAR certification preferred.
  • Previous data entry, programming, or office coordinator experience highly preferred.
  • Spanish bilingual highly desirable.

Benefits

  • Low healthcare insurance premiums.
  • 401(k) with employer match.
  • Paid Time Off (PTO).
  • Employee discounts.
  • Company-paid life insurance.
  • Short-Term and Long-Term Disability.
  • Cancer Insurance.
  • Accident Insurance.
  • Pet Insurance.
  • Tuition Reimbursement.
  • On-the-job training and skills development.
  • Opportunities for growth and advancement.
  • Employee Assistance Program.

Schedule

Full Time, 7 days on/7 days off, 8:45 AM – 8:00 PM.

Working Conditions

Modern, well-lighted, air-conditioned general work area with moderate noise levels. Occasional overtime required. May be at risk for exposure to blood and body fluids. Ability to sit, stand, or walk for moderate periods. Safe and efficient operation of office equipment, including copier, fax, printers, computer, telephone, adding machine, Medifax, and credit card machine. Requires reading printed materials, listening, and verbally responding to customers, staff, physicians, and visitors. Moderately heavy lifting (0-25 lbs.), reaching, stooping, pushing, pulling, bending, and twisting.

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