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Job Details

Requisition Number 16-0324
Post Date 3/14/2017
Title Front Office Representative - Ortho Pool
City Mesa
State AZ
Description

GENERAL STATEMENT OF DUTIES: Assists patients with healthcare questions and concerns via the telephone. Familiar with standard concepts, practices, and procedures. Relies on experience and judgment to plan and accomplish goals. Performs a variety of tasks.

ESSENTIAL FUNCTIONS: 

  1. Promptly greets and acknowledges patients. Informs MAs and Providers of patient’s arrival.
  2. Instructs patients in completion of medical history and patient information forms, and makes any necessary corrections to the patients account. Obtains accurate, complete demographic and insurance information and financial contract / consent on patient paperwork as well as interviewing patients and guarantors to obtain accurate information.
  3. Responsible for identifying and collecting co-payments, co-insurances and past due account balances.
  4. 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.
  5. Evaluates patient financial status and establishes payment plans based upon authority levels.
  6. 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.
  7. Screens upcoming appointments for required referrals and/or authorizations.
  8. Scans all new patient or updated patient information into computer (including: photo ID, insurance cards, referrals, and patient paperwork).
  9. Schedules follow up appointments, reviews with patient their estimated out of pocket responsibility for future appointments, reviews patient's insurance coverage and notifies patient if service requires an authorization or referral.
  10. Maintains general knowledge of insurance plans accepted by The CORE Institute.
  11. Communicates with the patients in the lobby if the physician or provider is running behind schedule.
  12. Responsible for maintaining a secure and accurate cash drawer. Responsible for daily balancing of cash drawer.
  13. Maintains strictest patient confidentiality.
The job holder must demonstrate current competencies for job position.

Requirements

EDUCATION:   

  • High school diploma or GED.

EXPERIENCE:

  1. Successful candidate must have a minimum of one year of patient registration experience in a medical
  2. office or healthcare setting.
  3. Requires knowledge of insurance rules and regulations, medical terminology, and computer scheduling systems.
  4. Must be able to communicate effectively with physicians, patients, and the public and be capable of
  5. establishing good working relationships with both internal and external customers.
  6. Must be able to communicate effectively with physicians, patients, and the public and be capable of
  7. establishing good working relationships with both internal and external customers.
  8. Must be able to type a minimum of 40 WPM. Bilingual (English/Spanish) strongly preferred. Previous experience in collecting money is preferred.

REQUIREMENTS:

KNOWLEDGE:

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

SKILLS:

  1. Skill in customer service and an understanding of The CORE code of conduct and culture.
  2. Skill in communicating effectively with physicians, clinical staff and the public.
  3. Skill in establishing good working relationships with both internal and external customers.

ABILITIES:

  1. Ability to maintain patient confidentiality.
  2. 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.
  3. Ability to type 40 wpm.
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The CORE Institute

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