Patient Services Representative, Ambulatory Internal Resource Pool, FT, Days
1 month ago
Job Summary This is an entry-level position in which 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. This job requires regional travel across all Prisma Health sites. Accountabilities Responsible for complete and accurate patient registration, precertification, 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 the database, completes the 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%) PATIENT ACCOUNTING/REGISTRATION/SCHEDULING Serves as a liaison between patients 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 forms and documents as required. Assists patients with ambulatory difficulties. Maintains the appointment book and follows office scheduling policies. Provides front office phone support as needed and outlined through cross-training programs. Responsible for gathering, accurately coding, and posting outpatient charges to superbills. Processes vouchers and private payments, including updating registration screens based on information on checks. Helps to process mail return statements and outgoing statements. 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. Processes edits and Customer Service and Collection Request for resolution within specified time frames. Maintains and updates current information on physician's schedules. Schedules surgeries, ancillary services, and follow-up outpatient appointments and admissions as requested. Oversees the waiting area, coordinates patient movement, reports problems or irregularities. (20%) BILLING/FEE TICKET PREPARATION/MEDICAL RECORDS MAINTENANCE Researches all information needed to complete the outpatient billing process, including getting charge information from physicians. Codes information about procedures performed and diagnoses on charges. Keys charge information into an online entry program. Processes and distributes copies of billings according to clinic policies. Delivers, transports, sorts, and files returned charts. Picks up lab reports, dictations, X-rays, and correspondence. 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 the proper location. (20%) INSURANCE/PRECERTIFICATION/PREAUTHORIZATION Assists 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 a 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. Maintains files with referral slips, medical authorizations, and insurance slips. (20%) COLLECTIONS AND OTHER FRONT OFFICE PRACTICE FUNCTIONS Collects payments at the time of service for daily outpatient visit services. 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 a collection agency, makes a recommendation to Clinical Dept. Practice Manager. Participates with other staff to follow up on accounts until a zero balance or turned over for collection. (10%) DATA ENTRY OPERATOR Enters all charge and same-day payment information for patient visits and hospital patients, verifying the accuracy of coding, charging, and patient insurance status. Backs up and closes computer files on a daily basis, logging as appropriate (i.e., closing all batches in accordance with policy). Registers new patients after verifying patient status on a computer inquiry. Updates financial information as indicated. (5%) MISCELLANEOUS Maintains strictest confidentiality. Participates in educational activities. As a representative of GHS Clinical Department, is expected to maintain a neat and professional appearance, demonstrate a commitment to serve at all times, and uphold guidelines set forth in the office manual. (5%) Supervisory/Management Responsibilities This is a non-management job that will report to a supervisor, manager, director, or executive. Minimum Education High School diploma or equivalent Minimum Experience No previous experience required Other Required Experience Associate Degree in a 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 Independence Pointe Facility 7001 Corporate Department 70019600 Ambulatory Internal Resource Pool 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. #J-18808-Ljbffr
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