Patient Services Representative, Pulmonology, FT, Days

Prisma Health; Columbia (SC); On-site; USD 30,000 - 40,000; Full time

Job summary

A leading healthcare provider is seeking a Front Office Coordinator to manage patient registration and assist with billing and insurance processes. The role requires excellent interpersonal skills and a basic understanding of medical coding. You will be responsible for ensuring efficient patient flow, managing appointments, and maintaining accurate patient records. Join us in transforming healthcare for the communities we serve.

Qualifications

• No previous experience required; experience in a multi-specialty group practice preferred.
• Basic understanding of ICD-9 and CPT coding preferred.

Responsibilities

• Responsible for complete and accurate patient registration and coding.
• Acts as liaison between patient and medical support staff.
• Processes unpaid accounts and assists patients with insurance forms.

Skills

Interpersonal Skills

Knowledge of ICD-9 and CPT coding

Education

High School diploma

Associate degree in a related technical field

Job description

Inspire health. Serve with compassion. Be the difference.

Job Summary

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

Essential Functions

1. All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference.
2. Responsible for complete and accurate patient registration, pre-certification, charge capture, and accurate coding of diagnoses given by physicians. Responsible for posting all payments and balancing with computer reports at day end. Requires high 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, and distributes billing information. Files insurance claims and assists patients with insurance forms. Processes unpaid accounts by contacting patients and third-party payers.
3. Acts as liaison between patient and medical support staff. Greets patients and visitors courteously. Checks in patients, verifies and updates insurance information, and obtains signatures on all necessary forms. Assists patients with ambulatory difficulties. Maintains appointment book and follows scheduling policies. Provides front office phone support as outlined through cross-training. Screens visitors and responds to routine requests. Gathers, codes, and posts outpatient charges. Processes vouchers and private payments, updating registration screens based on check information. Researches address verification as needed. Processes mail return statements and outgoing statements. Acquires billing information for all doctors for all patients. Performs cashiering functions including monitoring and balancing cash drawer daily. Prepares daily cash deposits. Receives payments, issues receipts, and codes and posts payments. Maintains records, reports, and files. Works with patients to secure prepayment sources or financial agreements. Participates with staff to resolve accounts, assists with outpatient coding and error resolution, and processes edits and collection requests within specified timeframes. Identifies trends and communicates issues to management. Updates patient account database. Maintains and updates physician schedules, schedules surgeries, ancillary services, and follow-up appointments. Answers questions regarding appointments and testing. Assembles patient charts for next-day visits, updates profiles for completeness and accuracy. Oversees waiting area, coordinates patient movement, reports issues.
4. Assists patients with questions on insurance claims, disability benefits, home health care, medical equipment, and surgical care. Processes benefit correspondence, signatures, and insurance forms to expedite payment. Assists with obtaining hospitalization or surgical pre-certification from insurance companies. Follows up with insurance companies to ensure coverage approval. Posts all actions and maintains permanent records of patient accounts. Answers patient inquiries about accounts. Confirms workers' compensation claims and prepares disability claims. Follows up with insurance to ensure claims are paid. Maintains files with referral slips, medical authorizations, and insurance slips.
5. Researches information needed to complete outpatient billing, including obtaining charge info from physicians. Codes procedures and diagnoses, enters charge info into online systems, and distributes billings per policy. Assists with outpatient coding and error resolution. Manages chart logistics, including pulling, delivering, sorting, filing, and refiling charts. Maintains orderly files, purges obsolete records, and destroys outdated records following procedures. Creates new patient charts, repairs damaged ones, and assists in record location and filing. Follows medical records policies and procedures.
6. Collects payments at the time of service for outpatient visits. Reviews accounts to ensure timely payment. Performs collection actions, including contacting patients and resubmitting claims. Evaluates financial status and establishes payment plans. Reviews accounts for possible collection agency assignment and resolves billing complaints. Participates in follow-up activities until accounts are settled or turned over. Gathers and verifies superbills daily. Enters charge and payment info, verifying accuracy. Prints daily reports, verifies charge entry balancing, and closes files daily. Registers new patients, updates financial info, and maintains confidentiality. Participates in educational activities and performs related duties as required. Maintains professional appearance and adheres to office guidelines.
7. Performs other duties as assigned.

Supervisory/Management Responsibility

• This is a non-management role reporting to a supervisor, manager, director, or executive.

Minimum Requirements

• High School diploma or equivalent; associate degree in a related technical field preferred.
• No previous experience required; experience in a multi-specialty group practice preferred.

In Lieu Of

• NA

Required Certifications, Registrations, Licenses

• NA

Knowledge, Skills, and Abilities

• Basic understanding of ICD-9 and CPT coding (preferred).

Work Shift

Day (United States of America)

Location

1 Medical Park Rd Richland

Facility

3280 Pulmonology 1 Med Park 300

Department

32801000 Pulmonology 1 Med Park 300 - Practice Operations

Share your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.