Patient Service Representative - Oncology
Company: Springfield Clinic
Location: Springfield
Posted on: April 16, 2024
Job Description:
The Patient Service Representative - Operations is responsible
for discussing insurance coverage, including usual and customary
charges, Medicare and Medical Assistance availability,
reimbursement options available for services, educating patients
regarding the Clinic's billing and credit policies, work with
patient's insurance carrier to verify benefits coverage for
treatment, and discuss any credit concerns regarding a past due
account and make special arrangements if necessary to assure
payment will be made in a timely manner.
Job Relationships
Reports to the Operations Manager or Director of the service
linePrincipal Responsibilities
- Verify/secure referrals.
- Verify coverage and benefits prior to treatment.
- Secure prior-approval and pre-authorizations.
- Perform review and action of Bad Debt, Collections, and
Denials.
- Maintain proficiency with insurance and billing issues and
serve as a resource to providers and staff.
- Prepare account action worksheets and submit to Patient
Accounting for charge corrections.
- Provide a positive impression to patients about the Clinic's
billing department.
- Enter/edit patient insurance coverage/demographic information
when necessary.
- Inform patients of the Clinic's billing and credit
policies.
- Answer questions that patients may have in regard to insurance
coverage and other billing issues.
- Respond to patient's verbal and written requests in a timely
fashion.
- Maintain statistics.
- Maintain proficiency with insurance and billing issues by
participating in Patient Accounting meetings and training sessions
as appropriate.
- Must be empathetic, yet responsive to patients while adhering
to Patient Accounting billing practices and guidelines.
- Provide coverage at other Springfield Clinic locations as
assigned.
- Comply with the Springfield Clinic incident reporting policy
and procedures.
- Adhere to all OSHA and Springfield Clinic training &
accomplishments as required per policy.
- Provide excellent customer service and adhere to Springfield
Clinic's Code of Conduct and Ethics Standards.
- Perform other job duties as assigned.
Education/Experience
- High School graduate or GED required.
- Minimum two to three (2-3) years experience in medical billing
and insurance preferred.
Knowledge, Skills and Abilities
- Ability to handle multiple tasks and prioritize in a fast-paced
environment required.
- Computer skills, including Microsoft Office,
preferred.
- Strong verbal communication and listening skills are
required.
- Knowledge of the computer systems with emphasis on registration
and insurance screens.
- Knowledge of Medicare, medical assistance and other third party
payors.
- Ability to work with patients of all ages in a courteous and
professional manner. Must be empathetic, yet responsive to Patient
Accounting billing policies and guidelines.
- Ability to tactfully work with patients with past due
accounts.
- Ability to meet quality and performance guidelines and work
with patients in a courteous and professional manner.
- Must have the ability to maintain composure under
stress.
- Manual dexterity required for use of telephone headset,
calculator and computer keyboard.
Working Environment
- Work in office environment.
- Use of telephone required.
- Involves frequent contact with staff and the public.
- Requires siting for long periods of time.
- Some bending and stretching required.
PHI/Privacy Level
HIPAA1
Keywords: Springfield Clinic, Springfield , Patient Service Representative - Oncology, Healthcare , Springfield, Illinois
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