Pediatric Surgery Patient Care Coordinator

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Position Overview

The role involves managing various aspects of the front office operations within a pediatric surgical 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 healthcare professionals. Responsible for payment posting and daily reconciliation with system reports. This position requires strong public interaction and exceptional interpersonal abilities. Manage patient pre-payments and uphold financial agreements prior to service delivery. Collect charge data, code, input into the database, complete billing procedures, and disseminate billing information. Submit insurance claims and assist patients in filling out insurance documentation. Address 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 patients in, confirm and update necessary insurance details in the patient accounting system. Secure signatures on all required forms and documents. Assist patients with mobility challenges. Maintain the appointment schedule and adhere to office scheduling protocols. Provide front office telephone support as necessary through cross-training initiatives. Screen visitors and address routine inquiries. Responsible for gathering, coding, and posting 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 statements. Gather billing information for all physicians for patients seen in the 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 options or financial agreements before service delivery. Work with colleagues to achieve account resolution. Assist with outpatient coding and error correction. Process edits and customer service requests for resolution within designated timeframes. Identify trends and communicate issues to management. Update patient account databases. Maintain current information on physician schedules. Schedule surgeries, ancillary services, and follow-up outpatient appointments as requested. Respond to inquiries regarding patient appointments and testing. Prepare 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%
• Support patients with inquiries related to insurance claims, disability benefits, home healthcare, medical equipment, and surgical services. Process benefit correspondence, signatures, and insurance forms to expedite the payment of outstanding claims. Assist 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 permanent records 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 data from physicians. Code details about procedures performed and diagnoses on charges. 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. Manage the delivery, transport, sorting, and filing of 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. Dispose of obsolete records and files in accordance with retention and destruction policies. 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 the computer system to ensure timely payment. Conduct collection actions, including contacting patients by phone and resubmitting claims to third-party payers. Assess patient financial status 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 concerns. Collaborate with colleagues to follow up on accounts until a zero balance is achieved or they 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, verifying the accuracy of coding, charges, 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 needed. Maintain strict confidentiality. Engage in educational activities. Perform related duties as required. As a representative of Prisma Health Clinical Department, 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. An Associate degree in a technical specialty program of at least 18 months in length is preferred.

No prior experience is required. Experience in a multi-specialty group practice setting is preferred.

In Lieu Of

• N/A

Required Certifications, Registrations, Licenses

• N/A

Knowledge, Skills, and Abilities

• Basic understanding of ICD-9 and CPT coding is preferred.

Work Shift

Day (United States of America)

Location

9 Medical Park Rd Richland

Facility

3465 Pediatric Surgery 9 Med Park 500

Department

Pediatric Surgery 9 Med Park 500-Practice Operations

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