PATIENT ACCESS SERVICES REP I, PATIENT FINANCIAL SERVS

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 be responsible for fulfilling managed care requirements and pre-certification needs. Will be accountable for accuracy of information entered and documentation provided. Will coordinate referral of account to appropriate PFS personnel, including Customer Service Representatives, Billers, and Patient Account Collectors.

Responsibilities

• Obtain necessary demographic and financial data through patient interviews, centralized scheduling system and system queries.
• Verify insurance benefits and enter patient demographic and financial data accurately.
• Fulfill managed care requirements and pre-certification needs.
• Coordinate referrals to appropriate PFS personnel.

Requirements

• PC and Windows literacy required.
• Extensive knowledge of insurance/managed care, including Medicare, Medicaid, Peach Care, Tricare, VA, Disability Adjudication Services, Vocational Rehabilitation, Children’s Medical Services, Cancer State Aid, Crime Victim’s Compensation Program, Knight’s Templar Eye Foundation, Managed Care (HMO, PPO, POS, Medicare HMO), COBRA, Worker’s Compensation, Georgia Indigent Care Trust Fund, Blue Cross (Georgia, Florida, out-of-state and FEP).
• Strong verbal communication skills.
• Knowledge of medical terminology.
• Understanding of CPT-4, HCPCS, ICD-9, and DRG coding.
• Thorough understanding and knowledge of patient type, financial class, insurance master, employer codes, clinic codes, physician coding, admission source codes, relationship codes, accommodation codes, special handling codes, medical service codes.
• Previous data entry, programming, office coordinator experience highly preferred.
• Spanish bilingual highly desirable.

Skills

• Technical/system skills/knowledge: PC and Windows literacy, HBOC Series 2000 ADT/PA, Florida Shared System, Medifax, Microsoft Office applications, Dr. Chart.
• Knowledge of insurance/managed care, including Medicare, Medicaid, Peach Care, Tricare, VA, Disability Adjudication Services, Vocational Rehabilitation, Children’s Medical Services, Cancer State Aid, Crime Victim’s Compensation Program, Knight’s Templar Eye Foundation, Managed Care (HMO, PPO, POS, Medicare HMO), COBRA, Worker’s Compensation, Georgia Indigent Care Trust Fund, Blue Cross (Georgia, Florida, out-of-state and FEP).
• Strong verbal communication skills.
• Knowledge of medical terminology.
• Understanding of CPT-4, HCPCS, ICD-9, and DRG coding.
• Related regulatory and legal requirements: Medicare Secondary Payer Questionnaire, Advance Directives (living wills, healthcare surrogate), medical necessity checking requirements, ABNs, letters of non-coverage, coordination of benefits.
• Reimbursement methodologies: percent-of charges, DRGs, discounted fee-for-service, fee schedule, cost-based, capitation, per diems.
• Ability to organize workload in an efficient manner and type 40 wpm accurately.

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

Pay

Details about pay are not specified in the job posting.

Schedule

The position is full-time, 12-hour day shift from 7a-7p.