Healthcare Customer Service Specialist

2 weeks ago

Greenville, South Carolina, United States Prisma Health Full time

Inspire health. Serve with compassion. Make a difference.

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 functions as outlined below.

Key Responsibilities

  • Ensure thorough and precise patient registration, pre-certification, charge capture, and accurate coding of diagnoses as provided by physicians. Responsible for the posting of all payments and reconciling with daily computer reports. This role demands exceptional public interaction and interpersonal skills. Facilitate patient pre-payments and uphold financial agreements prior to service delivery. Collect charge details, code, input into the database, finalize billing processes, and distribute billing information. Submit insurance claims and assist patients in completing necessary insurance documentation. Manage unpaid accounts by liaising with 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 all required forms and documents. Aid patients with mobility challenges. Maintain the appointment schedule and adhere to office scheduling protocols. Provide front office phone support as needed through cross-training initiatives. Screen visitors and respond to standard inquiries. Responsible for gathering, coding, and posting outpatient charges accurately. Process vouchers and private payments, updating registration screens as needed. Conduct address verification research as necessary. Assist in processing returned mail statements and outgoing correspondence. Collect billing information for all physicians regarding patients seen in practice. Execute 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 provision. Work alongside other staff to achieve account resolution. Assist with outpatient coding and rectify errors. Process edits and customer service requests for resolution within specified timelines. 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. Compile patient charts for the following day's visits. Ensure patient profiles are complete and accurate. 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 outstanding claims payments. Help patients complete necessary forms for hospitalization or surgical pre-certification from insurance providers. Follow up with insurance companies to ensure coverage approval. Document all actions and maintain permanent records of patient accounts. Address patient questions and concerns regarding their accounts. Confirm all workers' compensation claims with employees. Prepare disability claims promptly. Follow up with insurance companies to ensure claims are processed as directed. Maintain files containing referral slips, medical authorizations, and insurance documentation. - 20%
  • Gather all necessary information to complete the outpatient billing process, including obtaining charge details from physicians. Code information related to procedures performed and diagnoses accurately. 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 according to the established system. Maintain organized files. File all medical reports. Purge obsolete records and files stored. Dispose of outdated records following established retention and destruction procedures. Create new patient charts. Repair damaged charts. 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 the computer system to ensure timely payments. Conduct 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 complaints. Collaborate with other 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 specified practices daily. Enter all charge and same-day payment information for patient visits and hospital patients, ensuring accuracy in 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 appropriate (i.e., closing all batches in accordance with policy). Register new patients after verifying their status in the computer system. Update financial information as necessary. Maintain strict confidentiality. Engage in educational activities. Perform related duties as required. As a representative of Prisma Health, it is expected to maintain a 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 position is non-management and reports to a supervisor, manager, director, or executive.

Minimum Qualifications

High School diploma or equivalent OR Post-high school diploma.

No prior experience required.

Required Certifications/Registrations/Licenses

N/A

Alternative Qualifications

N/A

Additional 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.

Location

Centennial Way Practices.

Facility

2444 MCCW-Urology.

Department

MCCW-Urology-Practice Operations.

Share your talent with us. Our vision is simple: to transform healthcare for the benefit of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.

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