Patient Billing/Services Representative II

3 weeks ago


St Louis, United States Washington University in St. Louis Full time

Scheduled Hours 40 Position Summary Interacts directly with patients and families to schedule appointments, register demographics, obtain insurance information, and enter the information into the EMR. Determines and collects co-payments, percentage payments, and self-payments. Obtains or verifies referrals for managed care plans. Responsible for pre-arrival to visit work as it relates to patient registration and insurance verification. Job Description Primary Duties & Responsibilities Pre-Visit Work * Complete pre-visit work following department guidelines including EPIC work queues. * Verify insurance eligibility for all patient appointments two weeks prior to the date of service. Contact primary care providers for authorizations, documenting status and internal and external referral information in EPIC. Insurance verifications follow plan requirements and WUSM procedure. Visit Work * Register patients for Department of Pediatrics' appointments completely and accurately. Verification of patient demographics including home address, telephone numbers, contact person, and account guarantor. Collect, confirm, and enter insurance information in the patient account. * Ensure that the HIPAA Privacy Notice has been offered and documented in EPIC. Obtain and document permission signatures for assignment of benefits and treatment consents. * Determine, collect, and document payments following the department and WUSM guidelines. Maintain a copay collection rate of 90% or greater. * Offer to and complete the My Chart enrollment for the patient and the families following the Department of Pediatrics' and WUSM guidelines. Post -Visit Work * Schedule all appointment types for the Department of Pediatric visits. * Schedule interpreter services for patient appointments following department guidelines. * Assist patients and families by generating work and school notes, validating parking (when applicable), providing directions, and providing related visit information. * Follow Point of Service (POS) Payment Policy and the end of day closing procedures. Responsible for following HIPAA regulations at end of day closing. * Identify and report duplicate accounts that have been created in EMR per EPIC guidelines. Other Duties and Responsibilities * Maintain HIPAA compliance, skills/competencies and participates in in-services, staff programs, continuing education and cross training programs according to established standards and Washington University policies. * Comply with OSHA, state and federal regulatory sources/standards. * Preceptor for new staff. Working Conditions Job Location/Working Conditions * St. Louis Children's Hospital, Suites 2C and 2D * Pediatric Specialists, Children's Specialty Care Center, Suite 2E. * Washington University Physicians in Illinois, Memorial Hospital East, Shiloh IL. * Pediatric Specialists, Graham Rd, Suite 2010. * Travel to clinical sites other than employee's primary location may be required. * Normal office environment. * Patient care setting. * High noise environment. * Exposure to blood-borne pathogens. Physical Effort * Typically sitting at desk or table * Repetitive wrist, hand or finger movement * Using tools requiring high dexterity * Occasional lifting



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