Patient Services Representative
2 weeks ago
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.
Key ResponsibilitiesPatient Accounting/Registration/Scheduling- Serves as a 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.
- Responsible for gathering, accurately coding, and posting outpatient charges to superbills.
- Processes vouchers and private payments, to include 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 waiting area, coordinates patient movement, reports problems or irregularities.
- 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.
- 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- Destroys outdated records following established procedures for retention and destruction.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 proper location.
- 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 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.
- Collects payments at 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 collection agency, makes recommendation to Clinical Dept. Practice Manager.
- Participates with other staff to follow up on accounts until zero balance, or turned over for collection.
- Enters all charge and same-day payment information for patient visits and hospital patients, verifying accuracy of coding, charging, and patient insurance status.
- Backs up and closes computer files on a daily basis, logging as appropriate.
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