Customer Service Representative - Healthcare
Department: Ambulatory Services - CSA Pool
Full/Part Time/PRN: Full-Time
Experience and Education
Registration and Scheduling:a)Completes detailed patient demographic and insurance information in electronic medical record (EMR) system, selecting appropriate insurance plans and payors.b)Completes all required CMS forms following billing compliance standards and policies.c)Schedules patient appointments utilizing demographic and registration best practice model.
Phones: a)Answers patient phone calls utilizing UT Southwestern PURE concepts.b)Able to problem solve utilizing department protocols as necessary to meet patient¿s needs.c)Documents and routes patient communications appropriately following EMR and documentation standards.
Patient Check-in:a)Greets and directs patients and/or visitors to appropriate location, providing information as needed.b)Confirms registration information and updates as appropriate; obtains pertinent information to complete all required forms.c)Collects outstanding patient balances on account and posts payments appropriately.d)Arrives patients in EMR following clinical front office best practices.e)Ensures all patients are continually informed of their visit status when appointments are delayed.
Patient Check-out:a)Per department standards, schedules appointments and follow-up visits and/or surgery, laboratory testing, etc. to ensure efficiency of patient care.b)Receives patient payments, enters payment information per standard into billing system, and provides receipt for payment to all patients.c)Collects outstanding patient balances on account and posts payments appropriately.
Insurance Verification: a.Verifies patient insurance benefits prior to patient appointments utilizing online and automated verification systems.b.Updates patient EMR documenting patient benefit information.c.Communicates with patients and check-in staff to ensure accurate patient payments are collected at time of service.
Referral Management:a)Schedules referral appointments utilizing EMR work queues following access to care standards.b)Confirms scheduling information and provides patient with any additional requirements.c)Documents all contact attempts with patient following policy and procedures.d)Tracks referral scheduling statuses and ensures referrals are completed in a timely fashion.
Billing activities:a)Pre-certifies third party payers; obtains referrals for patients; works closely with physicians and nurses regarding patient care issues.b)Maintains knowledge of relevant billing issues to reduce automated edits in the billing system.
2.Maintains high level of customer service to all internal and external customers.
3.Maintains patient confidentiality in accordance with university and department policy.
4.Maintains neatness of customer waiting area; keeps area stocked with pamphlets and other materials as appropriate.
5.May ensure adequate inventory of items necessary for day-to-day functions of clinic, such as office supplies and sample medications.
6.Duties performed may include one or more of the following core functions: (a) Directly interacting with or caring for patients; (b) Directly interacting with or caring for human-subjects research participants; (c) Regularly maintaining, modifying, releasing or similarly affecting patient records (including patient financial records); or (d) Regularly maintaining, modifying, releasing or similarly affecting human-subjects research records.
To the extent provided by applicable law, no person shall be excluded from participation in, denied the benefits of, or be subject to discrimination under any program or activity sponsored or conducted by The University of Texas System or any of its component institutions, on the basis of race, color, national origin, religion, sex, sexual orientation, age, veteran status, or disability.