Patient Services Representative, BMPG Plastics, Full-Time, Days

About the role

Responsible for aspects of front office management and operation as assigned. All team members are expected to be knowledgeable and compliant with Prisma Health's purpose: Inspire health. Serve with compassion. Be the difference.

Responsibilities

• Complete and accurate patient registration, pre-certification, charge capture and accurate coding of diagnoses given by physicians.
• Post all payments and balance with computer reports at day end.
• Public contact and excellent interpersonal skills required.
• Arrange 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, courteously, and helpfully.
• Check in patients, verify and update necessary insurance information in the patient accounting system.
• Obtain signatures on all required forms and documents.
• Assist patients with ambulatory difficulties.
• Maintain appointment book and follow office scheduling policies.
• Provide front office phone support as outlined through cross training program.
• Screen visitors and respond to routine requests for information.
• Gather, accurately code, and post outpatient charges.
• Process vouchers and private payments, including updating registration screens based on information on checks.
• Research address verification as needed.
• Process mail return statements and outgoing statements.
• Acquire billing information for all doctors for all patients seen in practice.
• 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 and maintain required records, reports and files.
• Work with patients to secure prepayment sources or financial agreements prior to providing service.
• Participate with other staff to achieve account resolution.
• Assist with outpatient coding and error resolution.
• Process edits and customer service and collection requests for resolution within specified time frames.
• Identify trends and communicate problems to management.
• Update patient account database.
• Maintain and update current information on physician’s schedules.
• Schedule surgeries, ancillary services, follow-up outpatient appointments and admissions as requested.
• Answer questions regarding patient appointments and testing.
• Assemble patients’ charts for next day visit.
• Update profiles on all patients, ensuring completeness and accuracy.
• Oversee waiting area, coordinate patient movement, report problems or irregularities.
• Assist patients with questions on insurance claims, obtaining disability insurance benefits, home health care, medical equipment, surgical care, etc.
• Process benefit correspondence, signature, and insurance forms to expedite payment of outstanding claims.
• Assist patients in completing all necessary forms to obtain hospitalization or surgical pre-certification from insurance companies.
• Follow up with insurance companies ensuring that coverage is approved.
• Post all actions and maintain permanent record of patient accounts.
• Answer patient questions and inquiries regarding their accounts.
• Confirm all workers’ compensation claims with employees.
• Prepare disability claims in a timely manner.
• Follow up with insurance companies ensuring that claims are paid as directed.
• Maintain files with referral slips, medical authorizations, and insurance slips.
• Research all information needed to complete outpatient billing process including obtaining charge information from physicians.
• Code information about procedures performed and diagnosis on charge.
• 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.
• Continually check for misfiled charts and refile according to filing system.
• Maintain orderly files and purge obsolete records following established procedures for retention and destruction.
• Make up new patient charts and repair damaged charts.
• Assist in locating and filing records; work with medical assistants and other staff to route patient charts to proper location.
• Follow medical records policies and procedures.
• Collect payments at time of service for daily outpatient visit services.
• Review each account via computer to ensure patient’s account(s) are being paid on a timely basis.
• Perform collection actions including contacting patients by telephone and resubmitting claims to third party reimbursers.
• Evaluate patient financial status and establish budget payment plans.
• Review accounts for possible assignment to collection agency and make recommendation to Clinical Department Practice Manager.
• Identify and resolve patient billing complaints.
• Participate with other staff to follow up on accounts until zero balance or turned over for collection.
• Gather and verify superbills for specified practice on a daily basis.
• Enter all charge and same day payment information for patient visits and hospital patients, verifying accuracy of coding, charging and patient insurance status.
• Print daily reports, verifying charge entry balancing at day end.
• Back up and close computer files on a daily basis, logging as appropriate.
• Register new patients after verifying patient status on computer inquiry.
• Update financial information as indicated.
• Maintain strictest confidentiality.
• Perform related work as required.
• As representative of Prisma Health Clinical Department, maintain neat and professional appearance, demonstrate commitment to serve at all times and uphold guidelines set forth in office manual.

Minimum Requirements

• Education: High school diploma or equivalent OR Post-high school diploma; Associate degree in technical specialty program of 18 months minimum in length preferred.
• Experience: No previous experience required; Multi-specialty group practice setting experience preferred.

Knowledge, Skills and Abilities

• Basic understanding of ICD-9 and CPT coding preferred.

Work Shift

Day (United States of America)

Location

Blount Memorial Hospital, BMPG Associates Boulevard Complex, BMPG Plastics 220 Associates Blvd