Patient Services Representative F/T Day

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 and verify/update insurance information.
• Obtain signatures on required forms and documents.
• Maintain appointment book and follow office scheduling policies.
• Provide front office phone support as needed and screen visitors/respond to routine requests for information.
• Gather, accurately code, and post outpatient charges.
• Process vouchers and private payments, including updating registration screens based on check information.
• Perform cashiering functions, including monitoring and balancing cash drawer daily and preparing 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 in account resolution, 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 and physician schedules.
• Schedule surgeries, ancillary services, follow-up outpatient appointments, and admissions.
• Answer questions regarding patient appointments and testing.
• Assemble patients’ charts for next-day visits and 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 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 of patient accounts.
• Answer patient inquiries regarding their accounts.
• Confirm workers’ compensation claims with employees and 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, and key 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.
• Maintain orderly files, purge obsolete records, and destroy outdated records following established procedures.
• Make up new patient charts, repair damaged charts, and assist in locating and filing records.
• Collect payments at time of service for daily outpatient visit services.
• Review accounts to ensure timely payment and perform collection actions, including contacting patients and resubmitting claims.
• 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, verifying accuracy of coding and insurance status.
• Print daily reports, verify charge entry balancing at day end, and back up/close computer files daily.
• Register new patients after verifying status on computer inquiry and update financial information as indicated.
• Maintain strictest confidentiality.
• Perform other duties as assigned.
• Maintain neat and professional appearance, demonstrate commitment to service, and uphold office manual guidelines.

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.
• High level of public contact and excellent interpersonal skills.

Schedule

Day (United States of America)