Patient Relations Executive

What you will do

Medical Insurance:

• Responsible for the accurate flow of medical information and patient data between physicians, patients and third-party payers with the use of accurate code to define diagnostics, treatments and procedures and to enter this information into a the facility’s database using medical coding protocol to produce a statement or claim.
• To act as a liaison between the facility and payment parties to investigate the claim, verify its information, and update the database in the instance that a claim is denied by the third-party payer.
• Review patient medical records
• Communicating with medical billing specialists to ensure treatment codes are accurately received
• Submission of claims
• Taking timely approval of investigations/ procedures.

Medical Invoicing:

• Invoicing the services as per the agreed prices.
• Receiving patient treatment codes to use in assembling reimbursement claims
• Make sure CPT codes are accurate as per service
• Billing patients for medical services
• Enter patient information into computer files, and possibly also in paper records
• Organize, manage, and sort paperwork (including patients’ charts)
• Continue to enter data as patients are subjected to diagnostic tests and receive treatments
• Prepare and mail billing statements
• Resolve conflicts regarding payments and reimbursements
• Investigate and report instances of insurance fraud
• Provide information and prepare documents for legal inquiries and litigation
• Ensure the confidentiality of patients’ personal information
• Perform clerical duties that may include answering the telephone, greeting patients, and sorting mail

Customer Service:

• Provides a high level of customer service to the patients.
• Interacts with client with professional and personal manner.
• Responds to questions according to regulatory protocols.
• Guides flow of clinic traffic and directs clients to open station.
• Maintains client schedule at clinics that have pre-scheduled appointment times.
• Assists in accurate and legible documentation of clinic forms.
• Assures every client is signed in and has completed clinic paperwork.
• Check consent/ insurance form for completeness and legibility before the client goes to the Registered Nurse for services.
• Communicates effectively with client regarding the information that is needed.
• Responds to urgent customer needs in a timely and professional manner.
• Makes recommendations and implements process improvements.
• Participates in fostering a safe workplace.
• Participates in employee job safety analysis to eliminate hazards and prevent accidents.

Cash Handling:

• Manage up-to-date clinic income records by sending and receiving bank checks and documenting all relevant transactions.
• Receives and reconciles cash, checks or credit card for payment and issues receipts as required
• Handles cash box as needed. • Accurately makes change when needed. • Responsible for cash box during clinic and transfers money to accounts department at end of clinic for deposit
• Handle all payments to clinic suppliers and accurately enter daily payment activities (credit, insurance, cash, check, payment for previous visit) into software management system
• Counts and reconciles money in cash drawers at the beginning and end of shifts to ensure that amounts are correct and notifies supervisor if any discrepancy is found
• Transfer income activities to the financial system on a daily basis
• Create daily, weekly, and monthly reports from clinic financial data
• Obtains valid authorization for all credit card payments
• In the event a refund is being requested, initiates checking the system for delinquent accounts or outstanding balance, suggests to apply payment of refund against outstanding balances before processing any refunds
• If a refund is necessary, ensures all appropriate documents and signatures are obtained, and refunds are entered in the system
• Maintains general knowledge of cash handling and controls and complies to cash handling policies and procedures
• Calculates total amounts received and reconciles with supervisor at the end of each shift before closing cash drawers
• Liaise and support other members of the multi-disciplinary team and other agencies relating to patient care, maintaining good communication channels.
• Be aware of safe guarding policies, both local and national, and implement such policies should it become necessary.