Patient Services Representative, Cardiothoracic Surgery, FT, 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 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, courteously, and helpfully; 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.
• Research address verification as needed; process mail return 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, issue receipts, code and post payments, and maintain required records.
• Work with patients to secure prepayment sources or financial agreements prior to service.
• Participate with staff to achieve account resolution; 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 current information on physician’s schedules; schedule surgeries, ancillary services, and follow-up appointments.
• Answer questions regarding patient appointments and testing.
• Assemble patients’ charts for next-day visits; update profiles ensuring 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 outstanding 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.
• Answer patient inquiries regarding their accounts; confirm workers’ compensation claims with employees.
• Prepare disability claims in a timely manner; follow up with insurance companies to ensure claims are paid.
• Maintain files with referral slips, medical authorizations, and insurance slips.
• Research information needed to complete outpatient billing process, including charge information from physicians.
• Code information about procedures and diagnoses on charges; key charge information into online entry program.
• Process and distribute copies of billings according to clinic policies; assist with outpatient coding and error resolution.
• 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 accordingly.
• 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.
• Work with medical assistants and staff to route patient charts to proper locations; follow medical records policies.
• Collect payments at time of service for daily outpatient visits; review accounts to ensure timely payment.
• 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; 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 and insurance status.
• Print daily reports, verify charge entry balancing at day end; back up and close computer files daily.
• Register new patients after verifying status on computer inquiry; update financial information as indicated.
• Maintain strictest confidentiality; participate in educational activities.
• Perform other duties as assigned; maintain neat and professional appearance.

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.

Skills

• Basic understanding of ICD-9 and CPT coding preferred.
• High level of public contact and excellent interpersonal skills.
• Commitment to maintaining strict confidentiality.

Schedule

Day shift