Medical Center Rep

Job Summary

Screens and refers all incoming calls and customers and or patients, manages customer and or patient flow, maintains current medical records, files secondary insurance, enters charges and payments, files secondary insurance, workers compensation claims, and corporate services claims, pursues collections daily, investigates patient billing inquiries, orders supplies and prepares mandatory computer generated reports. Performs business office functions within a medical clinic related to appointment scheduling, registration, claims management, cash collection, and medical records maintenance. During times of high patient volume and/or to assist with coverage, may be asked to float to other PPG clinics.

Qualifications
High School Diploma or GED (Required)

Work Experience
1 year of medical office experience is required (Preferred)
1 year experience with CPT and ICD-9 insurance coding (Preferred)
1 year of customer service experience (Required)

Licenses and Certifications
No Certifications are Required or Preferred

Essential Functions
PATIENT FLOW AND DATA COLLECTION:
Maintain patient flow and collect necessary data.
Manages patient flow to ensure that the patient is seen quickly and all information is available for treatment.
Create patient medical record folder for new patients and prepare medical record for use during physician visit.
Collects data as assigned such as vital signs, height, weight, etc.
Medical record management through established filing system.
Document management including, but not limited to transcription, incoming mail, diagnostic reports, copy requests, etc., to ensure data is available as needed to provide patient care.
Inquires of established patients if all information currently in the database is correct.
Takes appropriate actions to ensure patient is informed of scheduled appointment.
Collects data as assigned such as vital signs, height, weight, etc. which applies to specific departments

COORDINATE PATIENT PAYMENTS:
Collect, post and investigate patient payments in accordance with contractual agreements and financial obligation of the patient.
Informs or purses patient's co-pays and other patient responsibilities at the date of service
Operates the computer to enter patient's charges at time of completed services in a manner that will ensure accurate patient and insurance billing.
Accurately deposits or posts all payments to appropriate cost center accounts in agreement with the explanation of benefits per departmental specifics
Performs all necessary actions to ensure all respective insurance information is obtained and documented appropriately.
Accurately monitors or files all secondary insurance, workers' compensation insurance and corporate services insurance claims in a timely manner.
Performs a methodical review of explanation of benefits and follows all denials and delinquent pending claims.
Investigates all patient billing inquiries.

BUSINESS OFFICE FUNCTIONS:

Perform all business office functions for the medical clinic.
Screens and refers all incoming calls and visits to ensure that accurate and timely communications are facilitated and that the Center is always presented in a positive manner.
Inquires into the physician's orders for next visit and schedules the patient's next appointment.
Attach all transcription notes to the medical record and files all charts in a timely and appropriate manner.
Enters into the database, all information received from the change of address forms received from the post office, in a timely manner.
Assists in stocking, care and maintenance of department equipment and supplies.
Use proper procedures to inform management of defective office equipment.
Document all maintenance and repair to office equipment.
Responsible for preparing financial reports for respective area.
Takes meeting minutes in accordance with department and hospital guidelines

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.