Business Service Representative - SRS Business Services Centralized - Day Shift - PRN - Orange California

Company: SHARP HEALTHCARE
Location: Orange, California
Posted On: 04/25/2024

Hours:Shift Start Time:VariableShift End Time:VariableAWS Hours Requirement:Additional Shift Information:Weekend Requirements:As NeededOn-Call Required:NoHourly Pay Range (Minimum - Midpoint - Maximum):$23.100 - $28.514 - $34.217 -The stated pay scale reflects the range that Sharp reasonably expects to pay for this position.--- The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant's years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices. - -
What You Will Do
The Business Service Representative coordinates all registration functions necessary to ensure the processing of a clean claim including but not limited to obtaining and processing patient demographics, visit and financial information in a manner that facilitates maximum financial reimbursement and promotes outstanding customer service. The Business Service Representative ensures that each billing inquiry has outcome resolution in a timely manner and appropriate parties are informed.

Required Qualifications

• H.S. Diploma or Equivalent
• 2 Years experience in Business Office, Medical Insurance Billing or Scheduling Systems.
  Preferred Qualifications
  • Coursework in medical terminology
    Essential Functions
    
    
    
    • Patient Registration
      Authenticate and/or enroll patient at workstations where Patient Secure palm scanner is available. Follow established guidelines such as scripting and picture identification for enrollment and authentication. In absence of Patient Secure at workstation, use at least two patient identifiers to confirm patient identity. Notify MPI-DUPREG, document potential duplicate, and overlap registration when identified.
      Populate all demographic screens for new and established patients. Follow demographic establish guidelines.
      Complete regulatory required fields in demographic data with patient choices on regulatory forms such as Notice of Privacy Practice (NPP) and Advance Directives (ADHC).
      Secure patient signature on Condition of Registration (COR) and update date field in registration screen.
      Request and input Primary Care Provider (PCP) in demographic field.
      Provide New Patients with required information to Sharp Rees-Stealy (SRS) and resources to services.
      Registrations are 90% completed prior to services rendered.
      Promote Sharp Rees-Stealy self-service technology.
      
    • Patient Insurance
      Completes verification using online platforms (i.e. MPV Experian and insurance portals) as appropriate and/or utilizes telephone system to complete.
      Financial Status Classification (FSC) added to system accurately following department guidelines.
      Communicate eligibility concerns to patients and provide solutions as appropriate.
      Utilizes ARR system and other on-line request systems to update insurance dictionaries.
      Verifies invoices and makes necessary adjustments following department guidelines.
      Ensure documentation is clear and precise with patient communication or other concerns.
      
    • Insurance Authorization
      Obtains authorization as needed for clinics or special procedures.
      Monitors authorizations for insurance changes and resubmits authorization as needed.
      Communicates benefits for procedures and medical necessity requirements to clinical teams and/or physicians.
      Assist with retro-authorizations on services rendered as needed.
      Reviews and obtains vision authorization for billing and follows department guidelines.
      Insurance authorization number is recorded accurately in the appointment visit data form (VDF).
      Utilizes insurance authorization online portals as needed.
      
    • Financial Collections
      Provide estimates using price estimator.
      Request payment of co-pay, deductible, estimated out-of-pocket or good faith deposit as specified in department guidelines.
      Collect self-pay procedures and non-covered services following department guidelines.
      Provides patients with financial counseling and negotiates in a positive manner to collect open balances following department guidelines.
      Receive and post funds/credit card payments to correct invoices.
      Complete daily reconciliation balancing of payments of cash drawer following department guidelines.
      
    • Customer Service
      Use AIDET, key words at key times, on-stage behavior to contribute above 90th percentile on patient satisfaction.
      Displays empathy with patients under stressful situations and with frequent interruptions.
      Avoids jargon when communicating with patients.
      Adapt and protect patient privacy as needed (i.e. lowering voice, using face sheets vs verbal interviews depending on workstation setting).
      Practice good interpersonal and communication skills and ability to work well with others contributing to a team environment.
      Practice a positive and constructive attitude at all times.
      Perform service recovery when The Sharp Experience does not go right in accordance to Sharp's Behavior Standard Service Recovery.
      Ability to problem-solve, work independently and ability to escalate patient accounts.
      Communicates effectively both orally and in writing sufficient to perform essential job functions.
      
    • Demonstrates initiative and teamwork
      Prioritize job responsibilities effectively and informs leadership of backlog or slow volumes. Assists other areas when productivity volumes are low as identified by your department.
      Promotes a team approach in completion of department duties.
      Maintain the expected department productivity level as designated by the department.
      Contributes to team huddles and meetings suggesting ideas and solutions as appropriate.
      
    • Other duties and reports
      Provide department support and clinic needs as assigned and directed by leadership.
      Provide training and mentoring to new team members as directed by Leadership.
      Reviews and completes registration transaction editing (TES) system utilizing ETM Management reports online. Reports over 30-day registration TES edits to Leadership if unable to complete.
      Prescreens eligibility, patient benefits and authorizations for specific patient population.
      Reviews daily physician schedules to identify patients with financial concerns.
      Print and monitor new patient site reports for completion.
      Initiates and completes Business Communication Forms (BCF) forms following department guidelines.
      Process charge corrections, account adjustments, and statement reviews proficiently.
      Maintains up-to-date knowledge on new insurance plans and other information provided by Revenue Business Management (RBS). Utilizes RBS site for resources.
      Review self-service Kiosk administration tool for insurance updates.
      
      
      Knowledge, Skills, and Abilities
      • Ability to utilize resources in an organized manner.
        
      • General knowledge of office procedures.
        
      • Effective interpersonal and customer relations skills.
        
      • Strong professional level of written and oral communication skills.
        
      • Ability to diffuse volatile situations and use good judgment and tact in dealing with patients.
        
      • Bilingual English/Spanish preferred. ICD-9 coding, RVS coding and CPT coding.
        Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability or any other protected class
        H.S. Diploma or Equivalent More...

            

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