The Patient Providers Agent accepts patient recommendations; schedules appointments and preserves information in an electronic scheduling program; preregisters the client and creates accounts for clinical services; confirms and or obtains authorization for services; develops and keeps patient charts; and ensures that the patient account is prepared for billing.
Accepts referrals, validates for efficiency and appropriateness, interacting with referral sources to obtain extra information as required. Produces and keeps client charts. Ensures that charts include MD recommendation orders, past medical records, documents required for medical use, documents for client signature. Might help clinical diabetes staff by downloading patient meters. Might assemble and report systems of service data to Finance for productivity reports. Obtains secret information from patient or member of the family, consisting of market, monetary, and medical. Pre-registers patients into the patient accounting system, confirms insurance coverage, confirms co-payment requirements and obtains/completes all essential permissions, certifications, notices and government needed paperwork.
Prepares charge tickets for scientific services. In selected centers, audits every patient chart for chargeable services and takes corrective action to guarantee they are precise and total. Researches and clears issues determined by patient accounting systems required to guarantee total and appropriate billing of assigned claims. May post billing charges and collection of cash/credit invoices to client accounts. Might translate narrative diagnosis into ICD-9 codes and enter into billing system.
Schedules patients for preliminary and follow-up visits and keeps data in computerized scheduling program.
MINIMUM QUALIFICATION REQUIREMENTS
Current Basic CPR for Infants, Children, and Adults is required in some settings. Qualified Billing Coder chosen. High school graduate or comparable required. Certification, Partner or Bachelors Degree in Business or Healthcare associated field chosen.
Requires understanding of medical insurance concepts and requirements, consisting of HMO, PPO, Medicare, Medi-Cal, and other federal and state agency programs. Needs understanding of medical and billing terminology.
Requires experience in a health care setting or insurance coverage associated field offering client registration and/or insurance permission as usually acquired in approximately 2 years is highly desired. Strong customer service experience preferred.
Required to gather a range of details in a very precise manner in a quick paced environment, while keeping client privacy. Need to be able to utilize numerous complex tools to register and arrange clients. Need to be highly competent in verbal and written communication. Strong computer system abilities required. Needs math abilities. Needs customer support abilities. Requires attention to information. Should have capability to hear with or without assistive devices.
Sutter Medical Center.