Patient Services Representative, BMPG Cardiology, Blount, Full-Time, Days

About the Role

Responsible for aspects of front office management and operation as assigned. This role requires a high level of public contact and excellent interpersonal skills.

Responsibilities

• Complete and accurate patient registration, pre-certification, charge capture, and accurately coding diagnoses given by physicians.
• Post all payments and balance with computer reports at day end.
• Arrange for patient pre-payments and enforce financial agreements prior to providing service.
• Gather charge information, code, enter into database, complete billing process, and distribute billing information.
• File insurance claims and assist patients in completing insurance forms.
• Process unpaid accounts by contacting patients and third-party payers.
• Act as liaison between patient and medical support staff.
• Greet patients and visitors promptly and courteously; check in patients, verify and update insurance information.
• Obtain signatures on required forms and documents.
• Maintain appointment book and follow office scheduling policies.
• Provide front office phone support and screen visitors; respond to routine requests for information.
• Gather, accurately code, and post outpatient charges.
• Process vouchers and private payments, update registration screens based on check information.
• Perform cashiering functions including monitoring and balancing cash drawer daily; prepare daily cash deposits.
• Receive payments from patients and issue receipts; code and post payments, maintain required records and files.
• Work with patients to secure prepayment sources or financial agreements prior to service.
• Participate in account resolution efforts with other staff.
• Assist with outpatient coding and error resolution; process edits and customer service/collection requests within specified time frames.
• Identify trends and communicate problems to management; update patient account database.
• Maintain and update physician schedules; schedule surgeries, ancillary services, and follow-up appointments.
• Answer questions regarding patient appointments and testing.
• Assemble patient charts for next-day visits; update patient profiles for completeness and accuracy.
• Oversee waiting area, coordinate patient movement, and report problems or irregularities.
• Assist patients with insurance claims, disability benefits, home health care, medical equipment, and surgical care questions.
• Process benefit correspondence, signatures, and insurance forms to expedite payment of claims.
• Assist patients in completing forms for hospitalization or surgical pre-certification from insurance companies.
• Follow up with insurance companies to ensure coverage approval.
• Post all actions and maintain permanent records of patient accounts; answer patient inquiries regarding accounts.
• Confirm workers’ compensation claims with employees; prepare disability claims in a timely manner.
• Maintain files with referral slips, medical authorizations, and insurance slips.
• Research information needed to complete outpatient billing process, including obtaining charge information from physicians.
• Code information about procedures performed and diagnosis on charges; key charge information into online entry program.
• Process and distribute copies of billings according to clinic policies.
• Pull charts for scheduled appointments in advance; deliver, transport, sort, and file returned charts.
• Pick up lab reports, dictations, X-rays, and correspondence; check for misfiled charts and refile as needed.
• Maintain orderly files; file all medical reports; purge obsolete records following established procedures.
• Make new patient charts; repair damaged charts; assist in locating and filing records.
• Collect payments at time of service for daily outpatient visits; review accounts to ensure timely payments.
• Perform collection actions including contacting patients by telephone and resubmitting claims to third-party reimburses.
• Evaluate patient financial status and establish budget payment plans.
• Review accounts for possible assignment to collection agency and make recommendations to Clinical Dept. Practice Manager.
• Identify and resolve patient billing complaints; follow up on accounts until zero balance or turned over for collection.
• Gather and verify superbills for specified practice on a daily basis.
• Enter charge and same-day payment information for patient visits and hospital patients; verify accuracy of coding, charging, and insurance status.
• Print daily reports and verify charge entry balancing at day end; back up and close computer files daily.
• Register new patients after verifying patient status on computer inquiry; update financial information as indicated.
• Maintain strictest confidentiality.
• Perform other duties as assigned.

Requirements

• High school diploma or equivalent OR post-high school diploma.
• Associate degree in a technical specialty program of 18 months minimum in length preferred.
• No previous experience required; multi-specialty group practice setting experience preferred.
• Basic understanding of ICD-9 and CPT coding preferred.

Schedule

Day shift

Location

Blount Memorial Hospital, Maryville, TN