Patient Service Representative - Radiation Oncology

Springfield Clinic; Springfield (IL); On-site; USD 36,000 - 48,000; Full time

Job summary

Springfield Clinic is seeking a Patient Service Representative – Operations to handle insurance verification, benefits checks, prior authorizations, and patient billing questions. You will support providers and staff, maintain accurate records, and ensure timely payments while upholding policies and high standards of service.

Ideal candidates have strong communication, empathy, and multitasking abilities, with experience in medical billing and MS Office.

Qualifications

• High school diploma or GED required.
• 2-3 years medical billing/insurance experience preferred.
• Strong customer service and communication skills.

Responsibilities

• Verify/secure referrals.
• Verify coverage and benefits prior to treatment.
• Secure prior-approval and pre-authorizations.
• Review and act on bad debt, collections and denials.
• Maintain proficiency with insurance and billing issues for providers and staff.
• Prepare account action worksheets and submit to Patient Accounting for charge corrections.
• Provide a positive impression of the Clinic's billing department.
• Enter/edit patient insurance coverage/demographic information as needed.
• Inform patients of billing and credit policies.
• Answer questions on insurance coverage and billing issues.
• Respond to verbal and written requests promptly.
• Maintain statistics.
• Participate in Patient Accounting meetings and training to stay updated on billing issues.
• Be empathetic yet responsive to billing policies and guidelines.
• Provide coverage at other Springfield Clinic locations as assigned.
• Comply with incident reporting policy and procedures.
• Adhere to OSHA and Clinic training/accomplishments.
• Provide excellent customer service and uphold the Code of Conduct and Ethics Standards.
• Perform other duties as assigned.

Skills

Multitasking

Verbal communication

Empathy

Customer service

Attention to detail

Education

High School diploma or GED

2-3 years medical billing experience

Tools

Microsoft Office

Job description

Job Description

The Patient Service Representative - Operations is responsible for discussing insurance coverage, including usual and customary charges, Medicare and Medical Assistance availability, reimbursement options available for services, educating patients regarding the Clinic's billing and credit policies, work with patient’s insurance carrier to verify benefits coverage for treatment, and discuss any credit concerns regarding a past due account and make special arrangements if necessary to assure payment will be made in a timely manner.

The Patient Service Representative - Operations is responsible for discussing insurance coverage, including usual and customary charges, Medicare and Medical Assistance availability, reimbursement options available for services, educating patients regarding the Clinic's billing and credit policies, work with patient’s insurance carrier to verify benefits coverage for treatment, and discuss any credit concerns regarding a past due account and make special arrangements if necessary to assure payment will be made in a timely manner.

Job Relationships

Reports to the Operations Manager or Director of the service line

Principal Responsibilities

• Verify/secure referrals.
• Verify coverage and benefits prior to treatment.
• Secure prior-approval and pre-authorizations.
• Perform review and action of Bad Debt, Collections, and Denials.
• Maintain proficiency with insurance and billing issues and serve as a resource to providers and staff.
• Prepare account action worksheets and submit to Patient Accounting for charge corrections.
• Provide a positive impression to patients about the Clinic's billing department.
• Enter/edit patient insurance coverage/demographic information when necessary.
• Inform patients of the Clinic's billing and credit policies.
• Answer questions that patients may have in regard to insurance coverage and other billing issues.
• Respond to patient's verbal and written requests in a timely fashion.
• Maintain statistics.
• Maintain proficiency with insurance and billing issues by participating in Patient Accounting meetings and training sessions as appropriate.
• Must be empathetic, yet responsive to patients while adhering to Patient Accounting billing practices and guidelines.
• Provide coverage at other Springfield Clinic locations as assigned.
• Comply with the Springfield Clinic incident reporting policy and procedures.
• Adhere to all OSHA and Springfield Clinic training & accomplishments as required per policy.
• Provide excellent customer service and adhere to Springfield Clinic's Code of Conduct and Ethics Standards.
• Perform other job duties as assigned.

Education/Experience

• High School graduate or GED required.
• Minimum two to three (2-3) years experience in medical billing and insurance preferred.

Knowledge, Skills And Abilities

• Ability to handle multiple tasks and prioritize in a fast-paced environment required.
• Computer skills, including Microsoft Office, preferred.
• Strong verbal communication and listening skills are required.
• Knowledge of the computer systems with emphasis on registration and insurance screens.
• Knowledge of Medicare, medical assistance and other third party payors.
• Ability to work with patients of all ages in a courteous and professional manner. Must be empathetic, yet responsive to Patient Accounting billing policies and guidelines.
• Ability to tactfully work with patients with past due accounts.
• Ability to meet quality and performance guidelines and work with patients in a courteous and professional manner.
• Must have the ability to maintain composure under stress.
• Manual dexterity required for use of telephone headset, calculator and computer keyboard.

Working Environment

• Work in office environment.
• Use of telephone required.
• Involves frequent contact with staff and the public.
• Requires siting for long periods of time.
• Some bending and stretching required.

PHI/Privacy Level

HIPAA1