Job Description
Qualifications:
- 1+ years of Medical customer service experience (front desk, patient services, etc)
- Insurance knowledge (comfortable calling up insurances, looking up referrals, etc.)
- Computer knowledge and skills required, particularly Excel
- Critical thinking and multi-tasking skills required
- General knowledge and experience using EMR systems
Plusses
- Bachelor's degree or higher
- Third-party insurance knowledge
- Athena experience (EMR system)
Day-to-Day
- Answer telephones handling multiple phone lines
- Route patient calls to appropriate area/individual
- Schedule and cancel's appointments; Schedule patients for outpatient tests and surgeries
- Prepare for day, reviews eligibility and phone reports, prepares new patient charts and/or paperwork at patient presentation
- Greet patients and visitors Informs patient of privacy policies and procedures; Informs patients of delay's in physician schedules
- Perform registration to ensure demographic and insurance information is accurate and complete
- Comply with department procedures and regulatory guidelines for HIPAA, Advance Beneficiary Notice, Advance Directives, and Patients Rights
- Obtain copies of insurance cards, driver's license, authorizations, and referrals; enters into system
- Collect co-payments and outstanding balances at check-in, and time of service balances and estimated balances at check-out
- Refer patients to Central Billing Office staff regarding past due balances, questions and/or resolution
- Review and comply with patient account notes and appointment Notes in system
- Confirm charges / approves claim creations in system at Check-Out; Validates and submits claims for real time adjudication; Work "Day End Review" report and designated Tier-based HOLD Claim Worklists on a daily basis
- Schedule follow-up appointments, creates appointment ticklers in system, and works associated Worklists/boxes relative to both based on assignment
- Complete referrals and pre-authorizations as required
- Create a Time of Service batch and links it to a deposit batch daily; Reconciles, balances, and closes each batch /drawer at end of day; Turns over batches to designated resource daily
- Perform clerical duties including, but not limited to processing mail, confirming appointments, sending out follow-up notices, and maintaining statistics
- Perform other duties as assigned and may be assigned to other Capital Health Medical ! Group Practices ! as needed
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