Patient Relations Executive

11 أكتوبر، 2022

0 4 3 دقائق

الوصف الوظيفي

Overview of the role

Provide end to end operational support to the patients including but not limited

to insurance, appointments & invoicing and general customer service.

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.

المهارات

Required Skills to be successful

Have knowledge to undertake the below mentioned multidisciplinary tasks;

Medical Insurance Coding
Medical Invoicing
Cash Handling
Customer relations

Behavioural Competencies:

Excellent presentation and analytical skills
Exceptional written and oral communication skills
Good decision making skills
Strong operational thinking skills
Critical Thinking
Conflict Management
Ability to read fine print at times.
Multi-Tasking
Customer service skills to include; diplomacy, patience, problem solving with a range of clientele

What equips you for the role

Minimum Qualifications and Knowledge:

Graduate Degree in any stream.
Experience in all or any area of Insurance, Cash Handling, Customer Service & Invoicing.
Fluency in English (speak, read and write).
Arabic speaking skills will be an added advantage.
Excellent Computer Literacy skills is required.

Minimum Experience:

Minimum 2 experience in a similar role.