CUSTOMER SVC REP

Overview

To insure and oversee that the daily functions/operations of the clinic are in conjunction with the needs of the physicians, nursing/ancillary support staff and patients. In addition, to obtain/oversee the process in which patient demographic/ financial information is acquired to insure quality patient care and appropriate reimbursement for patients, physicians and The Methodist Hospitals, Inc.

Responsibilities

PRINCIPAL DUTIES AND RESPONSIBILITIES(*Essential Functions)

Enters patient demographic and financial information accurately into the computer for purposes of billing with appropriate agency.

Obtains all necessary documents related to patient's identification and insurance.

Obtains all necessary signatures and issues all regulatory documents.

Reconcile patient charges with services provided in the clinic.

Data submitted to appropriate billing agencies for payment of physician services.

Assigns and enters diagnosis codes for all outpatient diagnostic accounts and inputs charges.

Verifies insurance eligibility for all patients and obtains all necessary pre-certifications and/or prior authorizations.

Assists patient in arranging financial assistance prior to appointment on all cash account and/or co-pays.

Collects and processes co-pays as appropriate. Processes reports as appropriate.

Maintains department statistics.

Registers patients for NST's on non-clinic days.

Transports medical charts/equipment from NLC clinic to SLC clinic.

Qualifications

JOB SPECIFICATIONS(Minimum Requirements) KNOWLEDGE, SKILLS, AND ABILITIES

Must possess a working knowledge of Federal billing regulations governing Medicare and Medicaid programs as well as private payers.

Successfully passes the Medical Terminology class within six (6) months of hire.

Successfully passes the ICD-9 and CPT coding exam within six (6) months of hire.

Must be able to type a minimum of 35 wpm.

Proficient use of personal computer and computer keyboard necessary and successfully passes the computer proficiency exam.

Successfully passes the Epic Proficiency exam(s) for the application(s) applicable to job requirements. EDUCATION

High School Diploma/GED Equivalent Required

Associates Preferred

2 Healthcare/Medical Required STANDARDS OF BEHAVIOR Meets the Standards of Behavior as outlined in Personnel Policy and Procedure #1, Employee Relations Code. CONFIDENTIALITY/HIPAA/CORPORATE COMPLIANCE Demonstrates knowledge of procedures for protecting and maintaining security, confidentiality and integrity of employee, patient, family, organizational and other medical information. Understands and supports the commitment of Methodist Hospitals in adhering to federal, state and local laws, rules and regulations governing ethical business practices for healthcare providers. DISCLAIMER - The above statements are intended to describe the general nature and level of work being performed by people assigned to this job. The statements are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required.

Day/Evening Rotation