Patient Services Representative

Position Summary:
Performs general business office functions that may include some or all of the following: charge capture and over-the-counter payment posting; insurance verification and eligibility; insurance pre-authorization/pre-certifications; counseling patients and families on insurance and payment issues prior to surgery. Ensures all insurance, demographic, and eligibility information is obtained from patients and entered into the billing system in an accurate and timely manner. Registers patients in the system. Collects and revises all patient insurance information. Collects co-pays, deductibles and other out of pocket amounts at the time of service. Posts approved adjustments to patient accounts. Balances receipts, reconciles daily work batches and prepares audit trail. Checks patients in for surgery.

Primary Responsibilities:

• Ensure overall total customer satisfaction.
• Greet patients in a courteous and professional manner.
• Answer all incoming calls in a courteous and professional manner.
• Respond to the patients' needs or direct them to the appropriate person for assistance.
• Take detailed messages and confirm the appropriate people receive them.
• Obtain overall operational knowledge of the center in order to assist in the triage process.
• Have insurance knowledge, i.e., be aware that HMO patients need a referral for each visit and which insurances the center accepts.
• Ensure that patients' needs are handled in a timely and efficient manner.
• Ensure that benefit verification and pre-certification is completed for each scheduled case.
• Schedule patients into the billing system immediately upon receipt of the information from the surgeon offices.
• Prepare new chart including a copy of the insurance card(s), demographic information sheet, any referrals and obtain any signatures on center required paper work.
• Established patients - verify demographic and insurance information at each visit.
• Have knowledge of CPT-4 and ICD-9 coding, as well as the changing Medicare and Medicaid regulations and guidelines.
• On the day of surgery, enter patient charges, payments and approved discounts into the billing system.
• Collect unmet deductibles, coinsurance, co-payments and outstanding past due patient balances on the day of surgery.
• Ensure that paperwork processing is confidential, efficient and timely.

Position Description:

• Balance out at the end of day and perform necessary End of Day process for the center.
• Pull patient charts for the next day's appointments by the end of the current day.
• File all charts by the end of the day.
• Open and distribute all incoming mail and packages in accordance with policies and procedures.
• Maintain a neat and orderly workspace and an adequate supply of charts, forms and tools to perform the job.
• Maintain strictest confidentially of all information related to medical records,
  communication between staff and the patient as well as any events surrounding the patients' treatment.
• Perform all other duties as assigned.

Qualifications:

• Education: High School Diploma or GED required. College degree a plus.
• Experience: Two years minimum front office experience in an ASC or medical office.
• Prior use and experience with medical billing applications.
• CPT and ICD-9 coding experience required.
• Skills and Abilities: Excellent communication skills, both written and verbal.
• Ability to work independently.
• Ability to understand and interpret policies and regulations.
• Strong information systems knowledge - particular knowledge of Microsoft Windows, Excel and Word
  required.