Patient Service Representative Lead

4 weeks ago

Billings, Montana, United States Intermountain Healthcare Full time
Job Summary:

This position is responsible for leading the patient service representative team in billing, follow-up, and resolving issues that delay or prevent payment of the patient's account within Intermountain's policies and procedures.

Key Responsibilities:
  • Acts as a team lead to schedule daily work load and ensure timely and accurate scheduling and registration activities. Provide support for cash reconciliation functions (if applicable). Assists PSRs in problem solving more complicated issues.
  • Coordinates scheduling with that of the practitioners schedules to ensure proper coverage of patient appointments and out-of-office calls. Facilitates training of new hires and other training initiatives. Performs quality assurance reviews on PSR Associates, documents findings, and provides information to leadership. Assists in the preparation of periodic reports crucial to the leadership decision making process.
  • Coordinates with clinical staff to obtain charge information for all patients. Codes procedures performed and diagnosis on charge. Acts as a resource for Practice Managers and Physicians with denials and coding questions. Coordinates copies of medical documentation with physician charges to support billing to third-party payers. Resolves complex patient billing inquiries and problems.
  • Greets patients. Answer phones, takes messages, returns calls and provides needed information, while documenting all phone calls accurately and completely in the electronic medical record (EMR).
  • Schedules patient appointments for visits, procedures, diagnostic tests, referrals and/or consultations.
  • Registers patients. Confirms, enters, and/or updates all required demographic data on patient and guarantor on registration system. Follows procedures when identifying patients.
  • Obtains copies of insurance card(s), forms of ID, and signature(s) on all required forms. Verify information on appropriate accounts to determine insurance coordination of benefits, pre-certification/prior-authorization. Complete the Medicare Secondary Payer (MSP) questionnaire when applicable. Verifies insurance to determine coordination of benefits and obtains authorization and/or referrals as required. Screens for non-covered services and waiver of liability (ABN) through automated screening at time of service.
  • Informs self-pay patients of liability due and prepayment requirements. Prepare estimate of procedures, calculates advance payment requirements on previous or bad debt and current balances. Refer potentially eligible patients to financial counseling and/or contract eligibility vendor(s). Refer complex or non-compliant patient financial issues to Clinic Manager or Revenue Service Center.
  • Collects patient payments and provides accurate receipt. Posts payments in system. Reconciles receipts with cash collected and complete required balancing forms. Documents patient account notes for all interactions/transactions.
  • Maintains department and/or individual work queues and reports as required.
  • Prepares medical records for patient appointments by compiling information from various sources to include authorizations and non-Epic documentation. Accurately scans medical records as required for Medical Group or specialty office.
  • Promotes mission, vision, and values of SCL Health, and abides by service behavior standards.
  • Performs other duties as assigned.
Requirements:

  • High school diploma or equivalent is required.
  • One (1) year front office or revenue cycle experience in a health care organization is required.
  • Regular attendance to perform work on site during regularly scheduled business hours or scheduled shifts is required.
  • Demonstrate understanding of health insurance and medical costs.
  • Excellent customer service skills, in person and via telephone.
  • Strong communication skills.
  • Excellent organizational skills.
  • Proficient computer skills.
  • A team player who handles multiple projects simultaneously in a fast paced environment.
  • Leads a positive work environment that is supportive of PSR associates, other colleagues, and patients needs.
Physical Requirements:

Interact with others by effectively communicating, both orally and in writing. Operate computers and other office equipment requiring the ability to move fingers and hands. See and read computer monitors and documents. Remain sitting or standing for long periods of time to perform work on a computer, telephone, or other equipment. May require lifting and transporting objects and office supplies, bending, kneeling and reaching.

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