Patient Services Representative F/T Day
Company: Prisma Health
Location: Easley
Posted on: May 27, 2023
Job Description:
Inspire health. Serve with compassion. Be the difference.
Job Summary
Incumbents are responsible for aspects of Physician Practice front
office management and operation as assigned. May be responsible for
some or all front office functions as detailed in the next
section.
Accountabilities
- Responsible for complete and accurate patient registration,
pre-certification, charge capture and accurately coding diagnoses
given by physicians. Responsible for posting all payments and
balancing with the computer reports at day end. Requires a high
level of public contact and excellent interpersonal skills.
Arranges for patient pre-payments and enforces financial agreements
prior to providing service. Gathers charge information, codes,
enters into database, completes billing process, distributes
billing information. Files insurance claims and assists patients in
completing insurance forms. Processes unpaid accounts by contacting
patients and third party payers. - 20%
- 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. Obtains signatures on
all forms and documents as required. Assists patients with
ambulatory difficulties. Maintains appointment book 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.
Responsible for gathering, accurately coding and posting outpatient
charges. Processes vouchers and private payments, to include
updating registration screens based on information on checks.
Researches address verification as needed. Helps to process mail
return statements and outgoing statements. Acquires billing
information for all doctors for all patients seen in practice.
Performs cashiering functions including monitoring and balancing
cash drawer daily. Prepares daily cash deposits. Receives payments
from patients and issues 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. Assists with outpatient coding and error resolution.
Processes edits and Customer Service and Collection Request for
resolution within specified time frames. Identify trends and
communicates problems to management. Updates patient account
database. Maintains and updates current information on physician's
schedules. Schedules surgeries, ancillary services and follow-up
outpatient appointments and admissions as requested. Answers
questions regarding patient appointments and testing. Assembles
patients' charts for next day visit. Updates profiles on all
patients, ensuring completeness and accuracy. Oversees waiting
area, coordinates patient movement, reports problems or
irregularities. - 20%
- Assist patients with questions on insurance claims, obtaining
disability insurance benefits, home health care, medical equipment,
surgical care, etc.Processes benefit correspondence, signature, and
insurance forms to expedite payment of outstanding claims. Assists
patients in completing all necessary forms to obtain
hospitalization or Surgical pre-certification from insurance
companies. Follows-up with insurance companies ensuring that
coverage is approved. Posts all actions and maintains permanent
record of patient accounts. Answers patient questions and inquiries
regarding their accounts. Confirms all workers' compensation claims
with employees. Prepares disability claims in a timely manner.
Follows-up with insurance companies ensuring that claims are paid
as directed. Maintains files with referral slips, medical
authorizations, and insurance slips. - 20%
- Researches all information needed to complete outpatient
billing process including getting charge information from
physicians. Codes information about procedures performed and
diagnosis on charge. Keys charge information into on-line entry
program.Processes and distributes copies of billings according to
clinic policies. Assists with outpatient coding and error
resolution. Pulls charts for scheduled appointments in advance.
Delivers, transports, sorts and files returned charts. Picks up lab
reports, dictations, X-rays, and correspondence. Continually checks
for misfiled charts and refiles according to filing system.
Maintains orderly files. Files all medical reports. Purges obsolete
records and files in storage. Destroys outdated records following
established procedures for retention and destruction. Makes up new
patient charts. Repairs damaged charts. Assists in locating and
filing records. Works with medical assistants and other staff to
route patient charts to proper location. Follows medical records
policies and procedures. - 20%
- Collects payments at time of service for daily outpatient visit
services. Reviews each account via computer to ensure patient's
account(s) are being paid on a timely basis. Performs collection
actions including contacting patients by telephone and resubmitting
claims to third party reimburses. Evaluates patient financial
status and establishes budget payment plans. Reviews accounts for
possible assignment to collection agency, makes recommendation to
Clinical Dept. Practice Manager. Identifies and resolves patient
billing complaints. Participates with other staff to follow up on
accounts until zero balance, or turned over for
collection.Participates in educational activities. Gathers and
verifies superbills for specified practice on a daily basis. Enters
all charge and same day payment information for patient visits and
hospital patients, verifying accuracy of coding, charging and
patient insurance status. Prints daily reports, verifying charge
entry balancing at day end. Backs up and closes computer files on a
daily basis, logging as appropriate (i.e. closing all batches in
accordance to policy). Registers new patients after verifying
patient status on computer inquiry. Updates financial information
as indicated. Maintains strictest confidentiality. Participates in
educational activities. Performs related work as required. As
representative of GHS Clinical Department, is expected to maintain
neat and professional appearance, demonstrate commitment to serve
at all times and uphold guidelines set forth in office manual. -
20%
Supervisory/Management Responsibility
This is a non-management job that will report to a supervisor,
manager, director, or executive.
Minimum Requirements
High School diploma or equivalent OR Post-high school diploma
No previous experience required
Required Certifications/Registrations/Licenses
N/A
In Lieu Of The Above Minimum Requirements
N/A
Other Required Skills and Experience
- Associate's Degree in technical specialty program of 18 months
minimum in length- Preferred
- Multi-specialty group practice setting experience -
Preferred
- Basic understanding of ICD-9 and CPT coding- Preferred
Work Shift
Day (United States of America)
Location
BEH Easley Family Med
Facility
2387 BE FM-Easley
Department
23871000 BE FM-Easley-Practice Operations
Share your talent with us! Our vision is simple: to transform
healthcare for the benefits of the communities we serve. The
transformation of healthcare requires talented individuals in every
role here at Prisma Health.
Keywords: Prisma Health, Asheville , Patient Services Representative F/T Day, Sales , Easley, North Carolina
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