JOB SUMMARY:
The basic function of the Patient Financial Services Representative is to work closely with the AR Department and Business Office to ensure timely claim submission and account follow-up, and to work closely with our patients to ensure 5-star customer service.
QUALIFICATIONS AND EDUCATION:
Education:
- High school diploma or equivalent is required.
- An Associate’s degree from a Medical Billing program is preferred.
Qualifications:
- 1-2 years of experience in insurance and billing procedures is preferred.
- Certified:
- Professional certification through HFMA or AAHAM preferred.
- Must possess excellent organizational and time management skills.
- Must be able to prioritize duties and communicate directly with patients, physicians, co-workers and vendors. Must have professional telephone etiquette and have professional and effective communication skills.
- Excellent computer skills required. Must be able to work with internet options for claims processing and status checks. Experience with Medent or CPSI software preferred.
- Must possess excellent working knowledge of medical insurance and billing procedures with understanding of HMO, PPO and indemnity plans. Must have working knowledge of entire billing process.
- Must be a team player and willing to work with all staff to get the job accomplished. Must maintain a cooperative working relationship with all co-workers and patients and handle difficult situations tactfully.
- In-depth understanding of contracts and proper payment methodology.
- Must have the ability to review and understand written material pertaining to Orthopedics and health care, including terminology and reimbursement issues.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
- Reviews and refers delinquent accounts for Collections.
- Processes checks received at OSS locations for daily deposit.
- Discusses payment arrangements with patients for outstanding patient balances.
- Runs reports of Daily Hospital Facility charges to ensure all charges are captured. Closes daily charges.
- Provides as-needed support for other patient accounting functions and special projects.
- Prepares patient statements.
- Processes account Insurance and personal refunds.
- Answers the billing hotline in a timely manner and assist patients who have billing questions and complaints
- Acts as a resource for internal customers concerning billing support. Serves as a resource for newly hired staff and new members of the department.
- Processes requests for billing records from patients, third parties and law offices, following HIPAA guidelines.
- Resolves account To Dos in the billing system.
- Reviews and resolves Billing Group emails.
- Monitors incoming faxes in system and on manual fax machine.
- Demonstrates good judgment in safeguarding OSS information to include confidentiality of all medical and patient information.
- Follows all policies and procedures of OSS.
- Other duties as assigned.