PATIENT SERVICES REPRESENTATIVE

About the position

The Patient Services Representative provides support for patients, providers, and patient services departments. The Patient Services Representative will assist with and be responsible for duties that include, but not limited to, insurance verification, prior authorizations for procedures and medications, coordinating incoming and outgoing referrals and assist with all aspects of AR/Billing. (Please note, this position is In-Office, M-F, 8-5)

Responsibilities

• Obtain benefit verification by utilizing Athena electronic eligibility or by contacting the actual insurance carriers.
• Contact insurance carriers to obtain authorizations for diagnostic ancillary services.
• Submit patient referrals to outside resources (i.e. cardiology, radiology).
• Submit authorization requests for medications; obtain approvals, denials, and work through appeals.
• Send patient medical records to outside entities per company policies in a timely manner.
• Request patient medical records from outside entities per company policies in a timely manner.
• Receive incoming faxes, sort and distribute to appropriate departments.
• Answer questions from patients regarding account balances.
• Document and maintain records on each open claim.
• Perform necessary follow-up to ensure proper payment is received.
• Identify and resolve billing issues.
• Follow-up on report status of past Insurance and patient accounts.
• Perform various collection actions including contacting patient by phone, correcting and resubmitting claims.
• Work daily insurance correspondence as needed.
• Answer questions from patients, co-workers, and insurance companies.
• Any other duties as assigned.

Requirements

• High School or equivalent
• 1+ years' experience obtaining insurance verification and authorizations
• 1+ years' experience with medical accounts receivable
• Knowledge of medical coding and claims