A Registrar or Patient Service Representative provides direct assistance to patients at a health care or long term care facility. Answers questions and helps resolve complaints; provides liaison with health care providers; may assist with coordinating appointments or addressing billing or insurance issues.
Processes and monitors billing and follow up of claims submitted for payment to insurance payors, governmental payors and state agencies.
Description:
Qualifications High School Diploma or GED (Required) Work Experience 2•3 years a structured business environment (Required) 2•3 years hospital, Physician office or insurance environment (Preferred)
Licenses and Certifications Required Certifications/Licensures:
CPAR certification or must be obtained within two years of employment Essential Functions
ATTENTION TO BILLING DETAIL
•PATIENT
ACCOUNT REP
Prepares billing and follow ups on claims in a timely manner. Performs accurate and timely billing and account reviews ensuring that accurate information has been reviewed before sending to applicable payors or state agencies. Conducts account review ensuring accurate billing information, enters and revises information as needed prior to claim being submitted. Prepares adjustment bills, rebills, reprints claims and/or other source documents. Processes failed claims in biller work file according to carrier specific requirements. Coordinates with concurrent review precert nurse and/or admitting staff on precertification requirements. Prepares daily productivity reports.
CUSTOMER SERVICE
•PATIENT
CLAIM ISSUES
Serves as liaison between patient, employer, and carrier in resolving claim issues. Communicates with patient, employer and carrier regarding claim status. Processes patient inquiry requests within 24 hours. Assists with Customer Service coverage duties as need arises.
KNOWLEDGE OF BUSINESS OFFICE DEPARTMENT GUIDELINES AND PROGRAMS
Demonstrates knowledge of ever changing payer guidelines and regulations, programs and machines used. Demonstrates mastery of computer programs and office machines used. Strong Performance includes mastery of the following skills, tasks and behaviors. Creates and maintains via account notes, all correspondence, whether written or verbal, including discussion with carriers, patients or guarantors. Scans correspondence into the system. Submits Medicare Credit Balance Report quarterly, necessary to ensure that Phoebe Putney Memorial Hospital remains compliant with CMS rules and regulation. Attends seminars and education relating to Medicare, Medicaid and Commercial. Attends and participates in hospital and departmental staff meetings.
DOCUMENTATION
Documents and submits required information and data in a timely fashion. Clearly and accurately documents designated processes, policies, products, service offerings, etc. Ensures that documentation is tailored to expected readers / users. Uses correct terminology. Conforms to required style and format. Additional Duties Adheres to the hospital and departmental attendance and punctuality guidelines. Performs all job responsibilities in alignment with the core values, mission and vision of the organization. Performs other duties as required and completes all job functions as per departmental policies and procedures. Maintains current knowledge in present areas of responsibility (i.e., self education, attends ongoing educational programs). Attends staff meetings and completes mandatory in-services and requirements and competency evaluations on time. Demonstrates competency at all levels in providing care to all patients based on age, sex, weight, and demonstrated needs. For non-clinical areas, has attended training and demonstrates usage of age•specific customer service skills. Wears protective clothing and equipment as appropriate. All Career Site links will be transferred to new URLs on January 31st, increasing performance and enhancing security. Your application data will be saved, but any bookmarked links will need to be replaced. All candidates with active applications will receive a notification with the new link once the URLs are live. Thank you for your patience! Phoebe Putney Health System is southwest Georgia's preferred career choice for professionals who want to improve the community's health by joining a respected, cutting-edge team. We offer you the opportunity to collaborate with the best colleagues in a friendly, close-knit setting that feels like family. Your career at Phoebe will allow you to apply learned skills, explore new paths and advance into greater opportunities. There's more for you at Phoebe. Phoebe is simply the best, most advanced healthcare provider in the region. If you want to work in the medical field, we are the preferred choice, with the best technology, the most specialists and the area's top talent. If you are searching for a non-clinical career that allows you to serve the community and grow, you'll also find us ideal. We're one of the area's premier employers, offering a close-knit culture, outstanding benefits and many ways to develop your career.
