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Patient Services Representative

2 months ago

Easley, South Carolina, United States Prisma Health Full time
Job Summary

This is a dynamic role that requires a high level of public contact and excellent interpersonal skills. As a Patient Services Representative, you will be responsible for aspects of Physician Practice front office management and operation as assigned.

Key Responsibilities
  • Responsible for complete and accurate patient registration, pre-certification, charge capture and accurately coding diagnoses given by physicians.
  • Responsible for posting all payments and balancing with the computer reports at day end.
  • Liaison between patient and medical support staff, greeting 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.
  • Screens visitors and responds to routine requests for information.
  • Responsible for gathering, accurately coding and posting outpatient charges.
  • Processes vouchers and private payments, to include updating registration screens based on information on checks.
  • Researches address verification as needed.
  • Helps to process mail return statements and outgoing statements.
  • Acquires billing information for all doctors for all patients seen in practice.
  • 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.
  • Works with patients in securing prepayment sources or financial agreements prior to providing service.
  • Participates with other staff to achieve account resolution.
  • Assists with outpatient coding and error resolution.
  • Processes edits and Customer Service and Collection Request for resolution within specified time frames.
  • Identify trends and communicates problems to management.
  • Updates patient account database.
  • Maintains and updates current information on physician's schedules.
  • Schedules surgeries, ancillary services and follow-up outpatient appointments and admissions as requested.
  • Answers questions regarding patient appointments and testing.
  • Assembles patients' charts for next day visit.
  • Updates profiles on all patients, ensuring completeness and accuracy.
  • Oversees waiting area, coordinates patient movement, reports problems or irregularities.
  • Assist 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.
  • Follows-up with insurance companies ensuring that claims are paid as directed.
  • Maintains files with referral slips, medical authorizations, and insurance slips.
  • 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.
  • Assists with outpatient coding and error resolution.
  • Pulls charts for scheduled appointments in advance.
  • Delivers, transports, sorts and files returned charts.
  • Picks up lab reports, dictations, X-rays, and correspondence.
  • Continually checks for misfiled charts and refiles according to filing system.
  • Maintains orderly files.
  • 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.
  • Follows medical records policies and procedures.
  • Collects payments at time of service for daily outpatient visit services.
  • Reviews each account via computer to ensure patient's account(s) are being paid on a timely basis.
  • 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.
  • Identifies and resolves patient billing complaints.
  • Participates with other staff to follow up on accounts until zero balance, or turned over for collection.
  • Participates in educational activities.
  • Gathers and verifies superbills for specified practice on a daily basis.
  • Enters all charge and same day payment information for patient visits and hospital patients, verifying accuracy of coding, charging and patient insurance status.
  • Prints daily reports, verifying charge entry balancing at day end.
  • Backs up and closes computer files on a daily basis, logging as appropriate (i.e. closing all batches in accordance to policy).