Patient Services Representative

Inspire health. Serve with compassion. Be the difference.

Responsible for aspects of front office management and operation as assigned.

• All team members are expected to be knowledgeable and compliant with Prisma Health's purpose:
  Inspire health. Serve with compassion. Be the difference.
• Responsible for complete and accurate patient registration, pre‑certification, charge capture and accurate coding of diagnoses given by physicians. Posting all payments, balancing with computer reports at day end. Requires a high level of public contact and excellent interpersonal skills. Arranges for patient pre‑payments and enforces financial agreements prior to providing service. Gathers charge information, codes, enters into database, completes billing process, distributes billing information.
  
  Files insurance claims and assists patients in completing insurance forms. Processes unpaid accounts by contacting patients and third‑party payers.
• 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.
  
  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 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/collection requests for resolution within specified time frames.
  
  Identifies 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.
• 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 coverage is approved. Posts all actions and maintains a 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 claims are paid as directed. Maintains files with referral slips, medical authorizations, and insurance slips.
• Researchers all information needed to complete outpatient billing process including getting charge information from physicians, coding information about procedures performed and diagnosis on charge. Keys charge information into online entry program. Processes and distributes copies of billings according to…