Inspire health. Serve with compassion. Be the difference.
Job Summary
Responsible for aspects of front office management and operation as assigned.
Essential Functions
* All team members are expected to be knowledgeable and compliant with Prisma
Health's values: Inspire health. Serve with compassion. Be the difference.
* Responsible for complete and accurate patient registration,
pre-certification, charge capture and accurately coding diagnoses given by
physicians. Responsible for posting all payments and balancing with the
computer reports at day end. Requires a high level of 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 process,
distributes billing information. Files insurance claims and assists patients
in completing insurance forms. Processes unpaid accounts by contacting
patients and third-party payers.
* Liaison between patient and medical support staff. Greets patients and
visitors in a prompt, courteous, and helpful manner. Checks in patients,
verifies and updates necessary insurance information in the patient
accounting system. Obtains signatures on all forms and documents as
required. Assists patients with ambulatory difficulties. Maintains
appointment book and follows office scheduling policies. Provides front
office phone support as needed and outlined through cross
training program. Screens visitors and responds to routine requests for
information. Responsible for gathering, accurately coding and posting
outpatient charges. Processes vouchers and private payments, to include
updating registration screens based on information on checks. Research
address verification as needed. Helps to process mail return statements and
outgoing statements. Acquires billing information for all doctors for all
patients seen in practice. Performs cashiering functions including monitoring
and balancing cash drawer daily. Prepares daily cash deposits. Receives
payments from patients and issues receipts. Codes and posts payments and
maintains required records, reports and files. Works with patients in
securing prepayment sources or financial agreements prior to providing
service. Participates with other staff to achieve account resolution. Assists
with outpatient coding and error resolution. Processes edits and Customer
Service and Collection Request for resolution within specified time
frames. Identify trends and communicates problems to management. Updates
patient account database. Maintains and updates current information on
physician’s schedules. Schedules surgeries, ancillary services and follow-up
outpatient appointments and admissions as requested. Answers questions
regarding patient appointments and testing. Assembles patients’ charts for
next day visit. Updates profiles on all patients, ensuring completeness and
accuracy. Oversees waiting area, coordinates patient movement, reports
problems or irregularities.
* Assists patients with questions on insurance claims, obtaining disability
insurance benefits, home health care, medical equipment, surgical care, etc.
Processes benefit correspondence, signature, and insurance forms to expedite
payment of outstanding claims. Assists patients in completing all necessary
forms to obtain hospitalization or Surgical pre-certification from insurance
companies. Follows-up with insurance companies ensuring that coverage is
approved. Posts all actions and maintains permanent record of patient
accounts. Answers patient questions and inquiries regarding their
accounts. Confirms all workers’ compensation claims with employees. Prepares
disability claims in a timely manner. Follows-up with insurance companies
ensuring that claims are paid as directed. Maintains files with referral
slips, medical authorizations, and insurance slips.
* Researches all information needed to complete outpatient billing process
including getting charge information from physicians. Codes information about
procedures performed and diagnosis on charge. Keys charge information into
on-line entry program. Processes and distributes copies of billings according
to clinic policies. Assists with outpatient coding and error
resolution. Pulls charts for scheduled appointments in advance. Delivers,
transports, sorts and files returned charts. Picks up lab reports,
dictations, X-rays, and correspondence. Continually checks for misfiled
charts and refiles according to filing system. Maintains orderly
files. Files all medical reports. Purges obsolete records and files in
storage. Destroys outdated records following established procedures for
retention and destruction. Makes up new patient charts. Repairs damaged
charts. Assists in locating and filing records. Works with medical
assistants and other staff to route patient charts to proper
location. Follows medical records policies and procedures. -
* Collects payments at time of service for daily outpatient visit
services. Reviews each account via computer to ensure patient’s account(s)
are being paid on a timely basis. Performs collection actions including
contacting patients by telephone and resubmitting claims to third party
reimburses. Evaluates patient financial status and establishes budget payment
plans. Reviews accounts for possible assignment to collection agency, makes
recommendation to Clinical Dept. Practice Manager. Identifies and resolves
patient billing complaints. Participates with other staff to follow up on
accounts until zero balance or turned over for collection. Participates in
educational activities. Gathers and verifies superbills for specified
practice on a daily basis. Enters all charge and same day payment information
for patient visits and hospital patients, verifying accuracy of coding,
charging and patient insurance status. Prints daily reports, verifying charge
entry balancing at day end. Backs up and closes computer files on a daily
basis, logging as appropriate (i.e. closing all batches in accordance with
policy). Registers new patients after verifying patient status on computer
inquiry. Updates financial information as indicated. Maintains strictest
confidentiality. Participates in educational activities. Performs related
work as required. As representative of Prisma Health Clinical Department, is
expected to maintain neat and professional appearance, demonstrate commitment
to serve at all times and uphold guidelines set forth in office manual. -
* Performs other duties as assigned.
Supervisory/Management Responsibility
* This is a non-management job that will report to a supervisor, manager,
director, or executive.
Minimum Requirements
* Education - High School diploma or equivalent OR Post-high school diploma.
Associate degree in technical specialty program of 18 months minimum in
length preferred
* Experience - No previous experience required. Multi-specialty group practice
setting experience - 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
Blount Memorial Hospital
Facility
BMPG Joule Street Alcoa
Department
BMPG Endocrinology Joule St
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.