ESSENTIAL FUNCTIONS
Describe the duties that must be performed in the job. Focus on the junction of the job
rather than the means used to achie1·e that junction. Focus on the required outcome of the
job tasks, rather than on the tasks themselves.
1. Collaborate with Patient Services personnel at other location(s) as appropriate to assure that the front desk is 'staffed' at all times.
2. Train new PSS staff on all technical requirements of their jobs and update as appropriate. Provide bi- weekly feedback to manager on new employees' progress.
3. Maintain current knowledge of Medicaid, Medicare, commercial insurance, and front-office processes to serve as a subject-matter resource for the PSS team and staff in other departments.
4. Provide backup support to the Patient Services Specialists as needed.
5. Develop a schedule to conduct periodic competency reviews of front office staff for ongoing skills development. Provide assessment to manager after training and/ or competency review sessions. Provide input for performance reviews.
6. Coordinate time off requests for self and staff with appropriate personnel to assure coverage.
7. Maintain open communications with the contracted billing company to resolve claims issues timely.
8. Perform the following functions for primary location. (Also serve as a resource to other location(s) as needed to assure listed functions are accomplished timely.
- Encounters and EOBs for assigned locations are sent to the contracted billing company daily.
- All rejected claims for assigned locations are followed through, both internally and with the billing company.
- A status update is available for all 'rejected' or unable to be billed encounters.
- Items/ tasks returned from the billing company are completed promptly.
9. Assist with researching "Unbilled" system issues to determine cause. Work with billing company and OSIS to reconcile.
10. Act as a resource to answer questions and provide analysis of complex adjustment issues on patient accounts. "Assist PSS staff and/ or patient(s) to review and reconcile accounts.
11. Provide reports and analysis to manager and CFO, as requested.
12. Periodically monitor PSS team's encounters to assure that insurance information, patient demographics, and income data are correct on patient accounts. Follow up with front office personnel, billing company, or insurance companies, as appropriate, to correct system discrepancies and reconcile billing issues.
13. Ensure employees adhere to company policies and legal regulations.
14. Identify issues or activities that affect timely claims processing and delay the revenue cycle. Send report of issues identified to manager. Issues include:
- Insurance not verified
- Incorrect Insurance information
- Missing or inaccurate income information
- Incorrect sliding fee information
- Incomplete encounters
15. Assist Support Services Analyst with resolving issues that impact the revenue cycle. (May involve periodic review of registration procedures.)
16. Assist patients to set up a plan to pay outstanding balances.
17. Professionally handle incoming calls from patients, including returning the calls and expediting requests in a timely manner.
18. Assign insurance verifications and other tasks to staff; track progress and provide constructive feedback as appropriate.
19. Inform manager of problems with work quality, issues between employees and other concerns in an effective, timely manner. Provide recommendations for problem resolution.
20. Suggest opportunities to build morale and create a supportive team environment. Build and maintain positive working relationships with co-workers using the principles of respect and good customer service.
21. Perform other duties and assume other responsibilities as apparent or delegated to you.
PHYSICAL REQUIREMENTS I WORK ENVIRONMENT
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perforn1 the essential functions.
While performing the duties of this job, the employee is regularly required to sit. The employee is frequently required to stand; walk and use hands. Specific vision abilities required by this job include close vision and ability to adjust focus. The employee may need to lift and / or move up to 25 pounds.
This position requires work in an office setting.