Patient Services Representative F/T Day

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 necessary insurance information in the patient accounting system.
• Obtain signatures on all required forms and documents.
• Maintain appointment book and follow office scheduling policies.
• Provide front office phone support as needed and 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 check information.
• 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, maintaining 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 visits.
• Update profiles on all patients, ensuring completeness and accuracy.
• Oversee waiting area, coordinate patient movement, and report problems or irregularities.
• Assist patients with questions on insurance claims, obtaining disability insurance benefits, home health care, medical equipment, and surgical care.
• Process benefit correspondence, signatures, 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 to ensure coverage is approved.
• Post all actions and maintain a 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 to ensure claims are paid as directed.
• Maintain files with referral slips, medical authorizations, and insurance slips.
• Research all information needed to complete the outpatient billing process, including obtaining charge information from physicians.
• Code information about procedures performed and diagnosis on charges.
• Key charge information into the 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 according to the filing system.
• Maintain orderly files and purge obsolete records following established procedures.
• Destroy outdated records following retention and destruction procedures.
• 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 the proper location.
• Follow medical records policies and procedures.
• Collect payments at the time of service for daily outpatient visit services.
• Review each account via computer 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 and make recommendations to the Clinical Dept. 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 other duties as assigned.
• Maintain neat and professional appearance, demonstrate commitment to service, and uphold guidelines set forth in the office manual.

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 (United States of America)