Healthcare Administrative Specialist

1 week ago

West Columbia, South Carolina, United States Prisma Health Full time

Empower health. Provide compassionate service. Make a meaningful impact.

Position Overview

Individuals in this role are tasked with managing various aspects of the front office operations within a Physician Practice. Responsibilities may encompass a range of front office duties as outlined below.

Key Responsibilities

  • Ensure thorough and precise patient registration, pre-authorization, charge documentation, and accurate coding of diagnoses as provided by physicians. Responsible for payment posting and reconciling with daily computer reports. This role demands high public interaction and exceptional interpersonal abilities. Facilitate patient pre-payments and uphold financial agreements prior to service delivery. Collect charge data, code, input into the database, complete the billing cycle, and disseminate billing information. File insurance claims and assist patients in filling out insurance forms. Manage outstanding accounts by reaching out to patients and third-party payers. - 20%
  • Act as a liaison between patients and medical support personnel. Welcome patients and visitors courteously and efficiently. Check in patients, confirm and update necessary insurance details in the patient accounting system. Secure signatures on required forms and documents. Assist patients with mobility challenges. Maintain the appointment schedule and adhere to office scheduling protocols. Provide front office phone support as necessary through cross-training initiatives. Screen visitors and address routine inquiries. Gather, accurately code, and post outpatient charges. Process vouchers and private payments, updating registration screens based on check information. Conduct address verification as needed. Manage returned mail statements and outgoing correspondence. Collect billing information for all physicians for patients seen in practice. Perform cashiering duties, including monitoring and balancing the cash drawer daily. Prepare daily cash deposits. Accept payments from patients and issue receipts. Code and post payments while maintaining necessary records, reports, and files. Collaborate with patients to secure prepayment sources or financial agreements before service delivery. Work with colleagues to resolve accounts. Assist with outpatient coding and error rectification. Process edits and customer service requests for resolution within designated timeframes. Identify trends and communicate issues to management. Update the patient account database. Maintain current information on physician schedules. Schedule surgeries, ancillary services, and follow-up outpatient appointments as requested. Address inquiries regarding patient appointments and testing. Organize patient charts for upcoming visits. Update patient profiles, ensuring completeness and accuracy. Oversee the waiting area, coordinate patient flow, and report any issues or irregularities. - 20%
  • Assist patients with inquiries related to insurance claims, disability benefits, home healthcare, medical equipment, and surgical care. Process benefit correspondence, signatures, and insurance forms to expedite the payment of outstanding claims. Aid patients in completing necessary forms for hospitalization or surgical pre-authorization from insurance providers. Follow up with insurance companies to ensure coverage approval. Document all actions and maintain a permanent record of patient accounts. Address patient inquiries regarding their accounts. Confirm all workers' compensation claims with employees. Prepare disability claims promptly. Follow up with insurance companies to ensure claims are paid as directed. Maintain files with referral slips, medical authorizations, and insurance documentation. - 20%
  • Research all necessary information to complete the outpatient billing process, including obtaining charge information from physicians. Code details about procedures performed and diagnoses. Input charge information into the online entry system. Process and distribute billing copies according to clinic policies. Assist with outpatient coding and error resolution. Retrieve charts for scheduled appointments in advance. Deliver, transport, sort, and file returned charts. Collect lab reports, dictations, X-rays, and correspondence. Regularly check for misfiled charts and refile them according to the established system. Maintain organized files. Purge obsolete records and files stored. Destroy outdated records following established retention and destruction procedures. Create new patient charts. Repair damaged charts. Assist in locating and filing records. Collaborate with medical assistants and other staff to route patient charts to the appropriate locations. Adhere to medical records policies and procedures. - 20%
  • Collect payments at the time of service for outpatient visits. Review each account via computer to ensure timely payments. Execute collection actions, including contacting patients by phone and resubmitting claims to third-party payers. Assess patient financial situations and establish budget payment plans. Review accounts for potential assignment to collection agencies and make recommendations to the Clinical Department Practice Manager. Identify and resolve patient billing issues. Collaborate with staff to follow up on accounts until they reach a zero balance or are referred for collection. Participate in educational activities. Gather and verify superbills for the specified practice daily. Enter all charge and same-day payment information for patient visits and hospital patients, ensuring the accuracy of coding, charging, and patient insurance status. Generate daily reports to verify charge entry balancing at the end of the day. Back up and close computer files daily, logging as necessary (i.e., closing all batches per policy). Register new patients after verifying their status in the computer system. Update financial information as needed. Maintain strict confidentiality. Engage in educational activities. Perform related tasks as required. As a representative of Prisma Health, it is expected to maintain a neat and professional appearance, demonstrate a commitment to service at all times, and uphold the guidelines set forth in the office manual. - 20%

Supervisory/Management Responsibility

This is a non-management position reporting to a supervisor, manager, director, or executive.

Minimum Qualifications

High School Diploma or equivalent.

No prior experience required.

Required Certifications/Registrations/Licenses

N/A

Alternative Qualifications

N/A

Other Required Skills and Experience

  • Associate's Degree in a technical specialty program of at least 18 months in duration - Preferred
  • Experience in a multi-specialty group practice setting - Preferred
  • Basic understanding of ICD-9 and CPT coding - Preferred

Work Schedule

Day shift.

Facility

Prisma Health.

Department

Practice Operations.

Share your expertise with us. Our vision is straightforward: to revolutionize healthcare for the benefit of the communities we serve. Transforming healthcare necessitates skilled individuals in every role at Prisma Health.

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