Patient Billing/Services Representative II - Pediatrics Ambulatory Care

Position Summary
Interacts directly with patients and families to schedule appointments, register demographics, obtain insurance information, and enter the information into the EMR. Determines and collects co-payments, percentage payments, and self-payments. Obtains or verifies referrals for managed care plans. Responsible for pre-arrival to visit work as it relates to patient registration and insurance verification.

Job Description

Primary Duties & Responsibilities

Pre-Visit Work  

• Complete pre-visit work following department guidelines including EPIC work queues.
• Verify insurance eligibility for all patient appointments two weeks prior to the date of service. Contact primary care providers for authorizations, documenting status and internal and external referral information in EPIC. Insurance verifications follow plan requirements and WUSM procedure.

Visit Work         

• Register patients for Department of Pediatrics’ appointments completely and accurately. Verification of patient demographics including home address, telephone numbers, contact person, and account guarantor. Collect, confirm, and enter insurance information in the patient account.
• Ensure that the HIPAA Privacy Notice has been offered and documented in EPIC. Obtain and document permission signatures for assignment of benefits and treatment consents.
• Determine, collect, and document payments following the department and WUSM guidelines. Maintain a copay collection rate of 90% or greater.
• Offer to and complete the My Chart enrollment for the patient and the families following the Department of Pediatrics’ and WUSM guidelines.

Post –Visit Work

• Schedule all appointment types for the Department of Pediatric visits.
• Schedule interpreter services for patient appointments following department guidelines.
• Assist patients and families by generating work and school notes, validating parking (when applicable), providing directions, and providing related visit information.
• Follow Point of Service (POS) Payment Policy and the end of day closing procedures. Responsible for following HIPAA regulations at end of day closing.
• Identify and report duplicate accounts that have been created in EMR per EPIC guidelines.

Other Duties and Responsibilities

• Maintain HIPAA compliance, skills/competencies and participates in in-services, staff programs, continuing education and cross training programs according to established standards and Washington University policies.
• Comply with OSHA, state and federal regulatory sources/standards.
• Preceptor for new staff.

Working Conditions

Job Location/Working Conditions

• St. Louis Children’s Hospital, Suites 2C and 2D
• Pediatric Specialists, Children’s Specialty Care Center, Suite 2E.
• Washington University Physicians in Illinois, Memorial Hospital East, Shiloh IL.
• Pediatric Specialists, Graham Rd, Suite 2010.
• Travel to clinical sites other than employee’s primary location may be required.
• Normal office environment.
• Patient care setting.
• High noise environment.
• Exposure to blood-borne pathogens.

Physical Effort

• Typically sitting at desk or table
• Repetitive wrist, hand or finger movement
• Using tools requiring high dexterity
• Occasional lifting <25 lbs.

Equipment

• Office Equipment

Preferred Qualifications

• Pediatric experience.
• Demonstrated interpersonal skills.
• Working knowledge of insurance and financial options.
• Interactive communication skills with the ability to work with physicians, patients, families, co-workers, other staff, and supervisor/manager.
• Strong organizational and telephone skills, and experience/knowledge of PC’s; electronic EMR and electronic scheduling and registration systems.

Required Qualifications

• High school diploma or equivalent high school certification with three years of experience in billing systems and third-party claims and/or experience in a medical office setting or related customer service/office experience or an equivalent combination of relevant education and experience.
• Basic Life Support certification. (Online BLS certifications, those without a skills assessment component, are not sufficient to meet the BLS requirements.). BLS certification must be obtained within one month of hire date.

Grade
C06-H

Salary Range
$17.00 - $24.66 / Hourly

The salary range reflects base salaries paid for positions in a given job grade across the University. Individual rates within the range will be determined by factors including one's qualifications and performance, equity with others in the department, market rates for positions within the same grade and department budget.

Questions

For frequently asked questions about the application process, please refer to our External Applicant FAQ .

Accommodation

If you are unable to use our online application system and would like an accommodation, please email [email protected]  or call the dedicated accommodation inquiry number at 314-935-1149 and leave a voicemail with the nature of your request.

Pre-Employment Screening
All external candidates receiving an offer for employment will be required to submit to pre-employment screening for this position. The screenings will include criminal background check and, as applicable for the position, other background checks, drug screen, an employment and education or licensure/certification verification, physical examination, certain vaccinations and/or governmental registry checks. All offers are contingent upon successful completion of required screening.

Benefits Statement

Personal

• Up to 22 days of vacation, 10 recognized holidays, and sick time.

• Competitive health insurance packages with priority appointments and lower copays/coinsurance.

• Want to Live Near Your Work and/or improve your commute? Take advantage of our free Metro transit U-Pass for eligible employees. We also offer a forgivable home loan of up to $12,500 for closing costs and a down payment for homes in eligible neighborhoods.

• WashU provides eligible employees with a defined contribution (403(b)) Retirement Savings Plan, which combines employee contributions and university contributions starting at 7%.

Wellness

• Wellness challenges, annual health screenings, mental health resources, mindfulness programs and courses, employee assistance program (EAP), financial resources, access to dietitians, and more!

Family

• We offer 4 weeks of caregiver leave to bond with your new child. Family care resources are also available for your continued childcare needs. Need adult care? We’ve got you covered.

• WashU covers the cost of tuition for you and your family, including dependent undergraduate-level college tuition up to 100% at WashU and 40% elsewhere after seven years with us.

For policies, detailed benefits, and eligibility, please visit: https://hr.wustl.edu/benefits/

EEO/AA Statement
Washington University in St. Louis is committed to the principles and practices of equal employment opportunity and especially encourages applications by those from underrepresented groups. It is the University’s policy to provide equal opportunity and access to persons in all job titles without regard to race, ethnicity, color, national origin, age, religion, sex, sexual orientation, gender identity or expression, disability, protected veteran status, or genetic information.

Diversity Statement
Washington University is dedicated to building a diverse community of individuals who are committed to contributing to an inclusive environment – fostering respect for all and welcoming individuals from diverse backgrounds, experiences and perspectives. Individuals with a commitment to these values are encouraged to apply.