Patient Service Rep Pediatric Surgery Full Time Days

East Tennessee Children's Hospital; Knoxville (TN); On-site; USD 36,000 - 52,000; Full time

Job summary

East Tennessee Children's Hospital seeks a patient-facing receptionist/billing support role to greet patients and collect information for encounters and billing outcomes. The position includes precepting new staff, aiding claim reviews, and contributing to daily financial reporting.

Work alongside the Practice Manager or Administrative Lead to monitor denied claims, coordinate billing with the Billing Office, and serve as a backup contact in their absence.

Qualifications

• Ability to multi-task while presenting a positive and comforting presence with patients and families.
• Efficient typing, filing and troubleshooting skills.

Responsibilities

• Answers incoming telephone calls in a courteous and helpful manner; relays messages and maintains confidentiality.
• Opens and routes incoming mail; retrieves charts; prepares new patient records and charts.
• Assists patient/families with required paperwork or verification documents for a complete patient file and billing record.
• Registers new patients and updates patient information in scheduling system; verifies subscriber information in computer system.
• Schedules follow-up appointments and provides forms for parents; verifies legal guardian information to ensure account completeness.
• Reviews procedure and diagnosis codes; assists with appeals of denials; serves as initial contact in absence of Manager/Lead.
• Maintains patient confidentiality and professional conduct; supports a courteous environment.
• Maintains provider schedules in eClinicaWorks; handles privacy and data security best practices.
• Completes training and required education; supports safe lifting and workplace safety.

Skills

Multi-tasking

Typing

Education

High School Diploma/GED

Associates Degree Preferred

Equivalent work experience

Job description

BASIC PURPOSE OF THE JOB

To greet patients and ensure all information is gathered for efficient encounters and billing outcomes. Responsible for precepting new employees, assisting with claim reviews and daily financial reporting. Works with Practice Manager or Admin Lead to monitor denied claims, coordinate billing efforts with Billing Office and serve as point of contact in absence of Manager or Lead.

REPORTS TO

• Practice Manager or Administrative Lead

JOB REQUIREMENTS

Supervisory Responsibilities: NO

Minimum Education: High School Diploma/GED; Associates Degree Preferred

Degree: will consider equivalent work experience/knowledge)

License/Certification Required: None

Minimum Work Experience: 1-2 years in Medical Office setting preferred

REQUIRED KNOWLEDGE, SKILLS, AND ABILITIES

• Ability to multi-task while presenting a positive and comforting presence with patients and families.
• Efficient typing, filing and troubleshooting skills.

DUTIES AND RESPONSIBILITIES

• Answers incoming telephone calls in a courteous and helpful manner: Answers inquiries and requests completely or refers calls to the appropriate contact. Relays complete, detailed messages and information to the appropriate individuals, while maintaining confidentiality of all information.
• Opens and routes incoming mail in a timely manner. Retrieves patient charts prior to visit and provides schedule to providers and staff. Prepares new patient records and charts.
• Assists patient/families with required paperwork or verification documents for a complete patient file and complete billing record.
• Registers new patients and updates patient information in scheduling system. Verifies and creates subscriber information in computer system. Copies, files and retrieves medical records as requested. Places calls to remind parents of appointment date and time.
• Schedules follow-up appointments and provides any necessary forms for parents. Interviews/identifies legal guardian to obtain necessary information to ensure account is complete. Helps identify problems to help ensure claims go out clean on the first submission.
• Reviews procedure code and diagnosis code. Works with RBO to appeal denials as needed, and provide records/information to assist to dispute denials. Serves as initial contact in absence of Manager/Lead.
• Demonstrates respect and regard for the dignity of all patients, families, visitors, and fellow employees to ensure a professional, responsible, and courteous environment. Interacts with all patients, staff, volunteers, etc. in a considerate, helpful, and courteous manner, as observed by management observation and peer input. Maintains professional composure and confidence during stressful situations.
• Works with Manager/Lead to create, edit and maintain provider schedules in eClinicaWorks. Maintains confidentiality of all hospital and patient information at all times as observed by management and peers. Will not discuss any patient information in public areas. Will not discuss any patient with friends, family who may call to ask about a child who has been here. Will only discuss accounts with other staff on a need to know basis to ensure payment of the claim or resolution of a problem. Only shares minimal information needed by others to do the job. Will not view accounts of friends, family member unless requested by the person responsible for the bill. Will hand off to another team member when working an account that could be considered a breach of privacy by a neighbor’s child, family member etc.
• Patient/Family Complaints are handled in a confidential, timely and professional manner. Calls are answered timely and families are given a response within 24 hours as observed by management. Serves as resource to PSRI to take initiative on accelerated calls before involving Practice Manager. Always ends conversation with family after a complaint or dispute with "is there anything else I can do for you today" as observed by management.
• Fosters mature professional relationships with fellow employees in a courteous, friendly, manner as measured by management observation and peer input. Promotes effective working relations and works effectively as part of a department/unit team inter-and intra-departmentally to facilitate the department’s/unit’s ability to meet its goals and objectives. Continuously displays a "can do" attitude within the practice and across other department lines to contribute to the overall focus on service excellence.
• Completes all ETCH and practice required training and CBL requirements: Attends all educational programs as needed. Practices safe lifting and body mechanic procedures. Maintains a safe and clean work area.
• Serves as mentor to new staff and provides leadership and education to those employees needing extra guidance. Willingly accepts any other assignment that may be requested.
• Utilizes hospital resources and time respectfully and accountably. Works as efficiently as possible to ensure best use of time.
• Collects deductibles, self-pays, receipts.
• Completes end-of-day financials: Balances credit card machines. Provides financial information to ETCH Financial Services team.
• Identifies missing charged, NDC indicators and assigns appropriate modifiers.
• Serves as mentor to new staff and provides leadership and education to those employees needing extra guidance.
• Works with Practice Manager to close identified gaps from payers to ensure maximum reimbursement/payments.
• Works with manager’s financial reports to identify trends or potential areas that need deeper research.

PHYSICAL REQUIREMENTS

• Note: Reasonable accommodations may be made for individuals with disabilities to perform the essential functions of this position.
• Light lifting, pushing and pulling is required for 10-20 lbs occasionally and frequent moving of objects of less than 10 lbs is required. Frequent sitting with some walking, standing, squatting, bending and reaching is required. Keyboard/computer use and/or repetitive motions may be required.

Come work where you can make a difference every day.