This patient service representative role is responsible for the front office management and daily operations of a urology practice. It involves patient registration, financial arrangements, and acting as a liaison between patients and medical staff, suiting a candidate with excellent interpersonal skills.
Responsibilities
Be knowledgeable and compliant with Prisma Health's purpose: Inspire health. Serve with compassion. Be the difference.
Perform complete and accurate patient registration, pre-certification, charge capture, and accurately code diagnoses given by physicians.
Post all payments and balance with computer reports at day end.
Arrange for patient pre-payments and enforce financial agreements prior to providing service.
Gather charge information, code, enter into database, complete billing process, and distribute billing information.
File insurance claims and assist patients in completing insurance forms.
Process unpaid accounts by contacting patients and third-party payers.
Greet patients and visitors in a prompt, courteous, and helpful manner.
Check in patients, verify and update necessary insurance information in the patient accounting system.
Obtain signatures on all forms and documents as required.
Assist patients with ambulatory difficulties.
Maintain appointment book and follow office scheduling policies.
Provide front office phone support as needed and outlined through cross-training program.
Screen visitors and respond to routine requests for information.
Gather, accurately code, and post outpatient charges.
Process vouchers and private payments, including updating registration screens based on information on checks.
Research address verification as needed.
Help process mail return statements and outgoing statements.
Acquire billing information for all doctors for all patients seen in practice.
Perform cashiering functions including monitoring and balancing cash drawer daily.
Prepare daily cash deposits.
Receive payments from patients and issue receipts.
Code and post payments and maintain required records, reports, and files.
Work with patients in securing prepayment sources or financial agreements prior to providing service.
Participate with other staff to achieve account resolution.
Assist with outpatient coding and error resolution.
Process edits and Customer Service and Collection Request for resolution within specified time frames.
Identify trends and communicate problems to management.
Update patient account database.
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Maintain and update current information on physician’s schedules.
Schedule surgeries, ancillary services, and follow-up outpatient appointments and admissions as requested.
Answer questions regarding patient appointments and testing.
Assemble patients’ charts for next day visit.
Update profiles on all patients, ensuring completeness and accuracy.
Oversee waiting area, coordinate patient movement, and report problems or irregularities.
Assist patients with questions on insurance claims, obtaining disability insurance benefits, home health care, medical equipment, surgical care, etc.
Process benefit correspondence, signature, and insurance forms to expedite payment of outstanding claims.
Assist patients in completing all necessary forms to obtain hospitalization or surgical pre-certification from insurance companies.
Follow-up with insurance companies ensuring that coverage is approved.
Post all actions and maintain permanent record of patient accounts.
Answer patient questions and inquiries regarding their accounts.
Confirm all workers’ compensation claims with employees.
Prepare disability claims in a timely manner.
Follow-up with insurance companies ensuring that claims are paid as directed.
Maintain files with referral slips, medical authorizations, and insurance slips.
Research all information needed to complete outpatient billing process including getting charge information from physicians.
Code information about procedures performed and diagnosis on charge.
Key charge information into on-line entry program.
Process and distribute copies of billings according to clinic policies.
Pull charts for scheduled appointments in advance.
Deliver, transport, sort, and file returned charts.
Pick up lab reports, dictations, X-rays, and correspondence.
Continually check for misfiled charts and refile according to filing system.
Maintain orderly files.
File all medical reports.
Purge obsolete records and files in storage.
Destroy outdated records following established procedures for retention and destruction.
Make up new patient charts.
Repair damaged charts.
Assist in locating and filing records.
Work with medical assistants and other staff to route patient charts to proper location.
Follow medical records policies and procedures.
Collect payments at time of service for daily outpatient visit services.
Review each account via computer to ensure patient’s account(s) are being paid on a timely basis.
Perform collection actions including contacting patients by telephone and resubmitting claims to third party reimburses.
Evaluate patient financial status and establish budget payment plans.
Review accounts for possible assignment to collection agency, make recommendation to Clinical Department Practice Manager.
Identify and resolve patient billing complaints.
Participate with other staff to follow up on accounts until zero balance or turned over for collection.
Participate in educational activities.
Gather and verify superbills for specified practice on a daily basis.
Enter all charge and same day payment information for patient visits and hospital patients, verifying accuracy of coding, charging, and patient insurance status.
Print daily reports, verifying charge entry balancing at day end.
Back up and close computer files on a daily basis, logging as appropriate (i.e., closing all batches in accordance with policy).
Register new patients after verifying patient status on computer inquiry.
Update financial information as indicated.
Maintain strictest confidentiality.
Perform related work as required.
Maintain neat and professional appearance, demonstrate commitment to serve at all times, and uphold guidelines set forth in office manual as a representative of Prisma Health Clinical Department.
Perform other duties as assigned.
Requirements
High school diploma or equivalent
Nice to have:
Associate degree in a technical specialty program of 18 months minimum in length
Multi-specialty group practice setting experience
Basic understanding of ICD-9 and CPT coding
About the Company
Prisma Health aims to transform healthcare for the benefit of the communities it serves.
