Patient Billing/Services Representative II - Pediatrics Ambulatory Medicine

Scheduled Hours

40

Position Summary

Interacts directly with patients and families to schedule appointments, register demographics, obtain insurance information, and enter the information into the EMR. Determines and collects co-payments, percentage payments, and self-payments. Obtains or verifies referrals for managed care plans. Responsible for pre-arrival to visit work as it relates to patient registration and insurance verification.

Job Description

Primary Duties and Responsibilities

Pre-Visit Work   

• Complete pre-visit work following department guidelines including EPIC work queues.
• Verify insurance eligibility for all patient appointments two weeks prior to the date of service.
• Contact primary care providers for authorizations, documenting status and internal and external referral information in EPIC. Insurance verifications follow plan requirements and WUSM procedure. 

Visit Work       

• Register patients for Department of Pediatrics’ appointments completely and accurately.
• Verify patient demographics including home address, telephone numbers, contact person, and account guarantor.
• Collect, confirm, and enter insurance information in the patient account.    
• Ensure that the HIPAA Privacy Notice has been offered and documented in EPIC.
• Obtain and document permission signatures for assignment of benefits and treatment consents.
• Determine, collect, and document payments following the department and WUSM guidelines.
• Maintain a copay collection rate of 90% or greater. 
• Offer to and complete the My Chart enrollment for the patient and the families following the Department of Pediatrics’ and WUSM guidelines.  

Post –Visit Work

• Schedule all appointment types for the Department of Pediatric visits. 
• Schedule interpreter services for patient appointments following department guidelines. 
• Assist patients and families by generating work and school notes, validating parking (when applicable), providing directions, and providing related visit information.
• Follow Point of Service (POS) Payment Policy and the end of day closing procedures. Follow HIPAA regulations at end of day closing.
• Identify and report duplicate accounts that have been created in EMR per EPIC guidelines.

Other Duties and Responsibilities

• Maintain HIPAA compliance, skills/competencies, and participate in in-services, staff programs, continuing education and cross training programs according to established standards and Washington University policies.
• Comply with OSHA, state and federal regulatory sources/standards.
• Preceptor for new staff.

Working Conditions

• St. Louis Children’s Hospital, Suites 2C and 2D
• Pediatric Specialists, Children’s Specialty Care Center, Suite 2E
• Washington University Physicians in Illinois, Memorial Hospital East, Shiloh IL
• Pediatric Specialists, Graham Rd, Suite 2010
• Travel to clinical sites other than employee’s primary location may be required.

Preferred Qualification

• Pediatric experience.
• Demonstrated interpersonal skills and working knowledge of insurance and financial options.
• Interactive communication skills with the ability to work with physicians, patients, families, co-workers, other staff, and supervisor/manager.
• Strong organizational and telephone skills.
• Experience and knowledge of PC’s, electronic EMR, and electronic scheduling and registration systems.

Required Qualifications

• High school diploma or equivalent high school certification with three years of experience in billing systems and third-party claims and/or experience in a medical office setting or related customer service/office experience or an equivalent combination of relevant education and experience.
• Basic Life Support certification. (Online BLS certifications, those without a skills assessment component, are not sufficient to meet the BLS requirements.). BLS certification must be obtained within one month of hire date.

Grade

C06-H

Salary Range

$17.34 - $25.40 / Hourly

The salary range reflects base salaries paid for positions in a given job grade across the University. Individual rates within the range will be determined by factors including one's qualifications and performance, equity with others in the department, market rates for positions within the same grade and department budget.

Questions

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