Sr. Clinic Office Specialist, FT, Days

About the Role

Responsible for patient registration, precertification, charge capture, and coding diagnoses given by physicians. This role involves receiving and interviewing patients to collect and verify pertinent demographic and financial data, verifying insurance, initiating pre-authorization processes, posting payments, and balancing reports at day end. The position also arranges for patient pre-payments and enforces financial agreements prior to providing service.

Responsibilities

• Interviews patients or other sources (in accordance with HIPAA Guidelines) to secure information relative to financial status, demographic data, and employment information.
• Enters accurate information into the computer database, accesses appropriate systems to ensure the most recent insurance card is on file, and scans documents according to departmental guidelines.
• Follows up for incomplete and missing information.
• Serves as a liaison between patient and medical support staff.
• Greets patients and visitors in a prompt, courteous, and helpful manner.
• Checks in patients, verifies and updates necessary insurance information in the patient accounting system (online Registration).
• Obtains signatures on all required forms and documents.
• Maintains office schedule and follows office scheduling policies.
• Provides front office phone support as needed and outlined through cross-training program.
• Screens visitors and responds to routine requests for information.
• Works work queues to completion (e.g., registration, charges, referrals).
• Processes vouchers and private payments, including updating registration screens based on information on checks.
• Helps to process mail return statements and outgoing statements.
• Reconciles and acquires billing information for all doctors for all patients seen in practice.
• Performs cashiering functions including monitoring and balancing cash drawer daily, preparing daily cash deposits, receiving payments from patients, and issuing receipts.
• Codes and posts payments and maintains required records, reports, and files.
• Works with patients in securing prepayment sources or financial agreements prior to providing service.
• Participates with other staff to achieve account resolution and assists with outpatient coding and error resolution.
• Processes edits and Collection Requests for resolution within specified time frames.
• Identifies trends and communicates problems to management.
• Updates patient account database.
• Maintains and updates current information on physician's schedules.
• Schedules surgeries, ancillary services, follow-up outpatient appointments, and admissions as requested.
• Assembles patient records and forms for next-day visits, updating profiles to ensure completeness and accuracy.
• Prepares and distributes appropriate reports, documents, and patient identification items as required.
• Researches all information needed to complete the outpatient billing process, including obtaining charge information from physicians.
• Codes information about procedures performed and diagnosis on charges.
• Keys charge information into the online entry program.
• Processes and distributes copies of documents according to clinic policies.
• Reviews patient records for scheduled appointments in advance.
• Delivers, transports, sorts, and files returned charts.
• Picks up lab reports, dictations, correspondence, etc.
• Scans appropriate information into the EHR.
• Destroys outdated records following established procedures for retention and destruction.
• Works with medical assistants and other staff to route patients and records to the proper location.
• Follows related EHR policies and procedures.
• Assists patients with questions regarding insurance claims, their accounts, obtaining disability insurance benefits, home health care, medical equipment, surgical care, etc.
• Processes benefit correspondence, signatures, and insurance forms to expedite payment of outstanding claims.
• Assists patients in completing all necessary forms to obtain hospitalization or surgical precertification from insurance companies, including waivers for cases where precertification is required but not yet obtained.
• Follows up with insurance companies to ensure coverage is approved.
• Posts all actions and maintains a permanent record of patient accounts.
• Confirms all workers' compensation claims with employees.
• Prepares disability claims in a timely manner.
• Follows up with insurance companies to ensure claims are paid as directed.
• Collects payments at the time of service for daily outpatient visit services.
• Evaluates patient financial status and establishes budget payment plans.
• Identifies and resolves patient billing complaints.
• Participates with other staff to follow up on accounts until zero balance or turned over to collection.
• Gathers and verifies information for specified practice on a daily basis.
• Enters same-day payment information for patient visits and hospital patients, verifying accuracy of coding, charging, and patient insurance status.
• Prints daily reports, verifying charge balancing at day end.
• Completes work queues on a daily basis.
• Registers new patients after verifying patient status on computer inquiry and updates financial information as indicated.
• Performs other duties as assigned.

Requirements

• High School diploma or equivalent.
• Associate degree in a technical specialty program of 18 months minimum in length preferred.
• Two (2) years in billing, bookkeeping, scheduling, and/or office procedure experience with medical insurance in a physician practice, hospital, or medical insurance processing work environment.
• Multi-specialty group practice setting experience preferred.
• In lieu of the education and experience noted above, an equivalent combination of work/academic experience may be considered (e.g., four years related work experience or a Bachelor's degree in Healthcare or Business).

Skills

• Strong interpersonal skills.
• Intermediate ICD-9 and CPT coding abilities preferred.

Schedule

Day shift (United States of America).