Patient Relation Rep V

Wilson County Is Hiring!

Are you detail-oriented, customer-focused, and experienced in patient services, billing, insurance, or financial assistance? Wilson County is seeking a Patient Relations Representative V to join our team!

This position plays an important role in assisting patients with billing and payment questions, explaining sliding fee scale eligibility, verifying insurance benefits, processing payments, resolving account denials, and helping patients understand their financial responsibilities.

Work Schedule: Monday–Friday, 8:00 a.m.–5:00 p.m., with additional hours as needed for special clinics.

If you’re looking for an opportunity to use your skills while making a positive difference in the lives of patients and the community, we encourage you to apply and join the Wilson County team!

1. Billing and Fee Collection:    50% 

Once a patient’s visit is complete, the Patient Relations Representative V is responsible for reviewing the encounter for accuracy and completeness and entering that information into the Electronic Health Record (EHR) in order to either bill the patient or the insurance company.   Encounters are entered daily to ensure timely submission and billing to Medicaid, Medicare and commercial insurance companies.  Incomplete or incorrectly coded encounters are tasked back to the provider to be corrected.  Once claims are submitted, the PRR is responsible for working and resubmitting any denied claims and making sure that payments are posted correctly.  Provide feedback to Supervisor and request assistance when there are billing issues that are not resolved.

Collect co-payments for insured customers and fees from customers without insurance.  Fee charges are determined by utilizing a sliding fee scale provided by the state and are based on the size and income of the family.  Payments are taken and applied to the appropriate account in the electronic health record.  At the end of the day, payments collected are counted and balanced with the day’s batch report out of the electronic health record.  All of which are turned in to the supervisor who generates a deposit slip.

 

C.Data Entry:     40%

 Ensure patient demographics are updated as patients come into the clinic.  Ensure proper information is entered into the Electronic Health Record (EHR) for maintenance of records, reports, and statistical data.  The Patient Relations Representative then records and bills all components using the ICD-10 and CPT codes provided electronically by clinic nurses.   Review encounters for accuracy and reconcile with HER.

 

D.Other Duties:     10%

1. Call, email, or fax referrals as ordered by the Mid-level provider
2. Ensure a superbill is received and signed by the Mid-level provider for each client served
3. Make copies of forms for clients
4. Scan outside lab results or other correspondence as needed into Electronic Health Record (EHR)
5. Prepare any letters or correspondence needed to assist RN clinic coordinator and or the Mid-Level provider
6. Prescriptions:   Type and print prescription labels periodically.
7. Review Electronic Health Record before clinic appointments.  Check for insurance coverage, outstanding balances, or patients needing financial updates before being seen in a clinic.
8. Provide LabCorp confirmation spreadsheet of patients with/without insurance to give to the finance manager.
9. Review death certificate report for patients in electronic health record and North Carolina Immunization Registry and update accordingly.
10. Main contact for Primary Care and Immunization billing and insurance issues – work with clerical staff assigned to these programs and the Primary Care and Immunization Program Coordinators.

Minimum Education and Experience

Graduation from high school and demonstrated possession of knowledges, skills and abilities gained through at least three years of office assistant/secretarial experience; or completion of a two-year secretarial science or business administration program with one year of responsible experience as described above; or an equivalent combination of training and experience.  

Equal Employment Opportunity Employer

Wilson County is an Equal Employment Opportunity Employer. We are committed to providing equal employment opportunities to all qualified individuals and do not discriminate on the basis of race, color, religion, sex, national origin, age, disability, or any other status protected by applicable law.