Front Office Representative PRN at The Center for Orthopedic and Research E

ESSENTIAL FUNCTIONS

• Promptly greets and acknowledges patients. Informs MAs and Providers of the patient’s arrival.
• Instructs patients in completion of medical history and patient information forms and makes any necessary corrections to the patient's account.
• Obtains accurate, complete demographic and insurance information and financial contract/consent on patient paperwork, as well as reviewing patients and guarantors to obtain accurate information assuring all necessary documents are populated and signed correctly. Ensure all required authorizations and/or referrals are attached to the appointment for that DOS.
• Responsible for identifying and collecting co-payments, co-insurances, and past-due account balances.
• Explains financial requirements to the patient in response to patient questions on billing and insurance matters; refers questions regarding more complex insurance/benefits questions to Site Billing Specialist.
• Evaluates patient financial status and establishes payment plans based upon authority levels.
• Responsible for accurately completing and interpreting insurance verification and benefits. Notifies patients, family members, physicians, and/or supervisors of network insurance coverage issues that may result in coverage reduction.
• Scans all new or updated patient information into the computer (including photo ID, insurance cards, referrals, and patient paperwork).
• Schedules follow-up appointments, reviews patient's insurance coverage and notifies patient if service requires an authorization or referral, and sends the request to PCP.
• Maintains general knowledge of insurance plans accepted by HOPCo.
• Communicates with the patients in the lobby if the physician or provider is running behind schedule.
• Responsible for maintaining a secure and accurate cash drawer. Responsible for daily balancing of the cash drawer and closing batch.
• Maintains strictest patient confidentiality.
• Maintains a clean and organized front office workspace.
• Follows established Front Office SOP’s.
• The job holder must demonstrate current competencies for the job position including a general understanding of insurance requirements.

EDUCATION

• High school diploma/GED or equivalent working knowledge preferred.

EXPERIENCE

• Minimum of one – two years of patient registration experience in a medical office or healthcare setting.
• Requires knowledge of insurance rules and regulations, medical terminology, and computer scheduling systems.
• Must be able to communicate effectively with physicians, patients, and the public and be capable of establishing good working relationships with both internal and external customers.
• Bilingual (English/Spanish) strongly preferred.
• Previous experience in collecting money is preferred.

KNOWLEDGE

• Knowledge of insurance rules and regulations including eligibility and referral requirements.
• Able to verify the eligibility of each payer, per patient according to defined parameters.
• Knowledge of medical terminology and HIPAA Guidelines.
• Computer knowledge, including Windows-based programs.

SKILLS

• Skill in customer service.
• Skill in communicating effectively with physicians, clinical staff, and the public.
• Skill in establishing good working relationships with both internal and external customers.

ABILITIES

• Ability to maintain patient confidentiality.
• Ability to communicate with upset and frustrated patients while consistently providing excellent customer service.
• Demonstrate empathy, concern, good listening skills, and compassion for all patients.

ENVIRONMENTAL WORKING CONDITIONS

• Normal office environment.
• Some travel between various clinic locations.

PHYSICAL/MENTAL DEMANDS

• Requires sitting and standing associated with a normal office environment.
• Some bending and stretching are required.
• Manual dexterity using a calculator and computer keyboard.

ORGANIZATIONAL REQUIREMENTS

• HOPCo Mission, Vision, and Values must be read and signed.

This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities, and working conditions may change as needs evolve.