Pre-Registration/Insurance Verification Rep - Part Time(
Job Number:
26601-97063)
Work Location
: United States-Ohio-Amherst-Lorain Business Office
Schedule
: Part-time
Description
Job Title: Pre-Registration/Insurance Verification Rep (Part-Time, Weekends only)
GENERAL SUMMARY OF DUTIES – Responsible for timely and accurate pre-registration and insurance verification. Accurately interprets managed care contracts.
SUPERVISOR –Pre-registration/Insurance Verification Team Leader or Manager
DUTIES INCLUDE BUT ARE NOT LIMITED TO:
• Perform pre-registration and insurance verification within 24 hours of receipt of
reservation/notification for both inpatient and outpatient services
• Follow scripted benefits verification and pre-certification format in Meditech custom benefits screen
and record benefits and pre-certification information therein
• Contact physician to resolve issues regarding prior authorization or referral forms
• Assign Iplans accurately
• Perform electronic eligibility confirmation when applicable and document results
• Research Patient Visit History to ensure compliance with payor specific payment window rules
• Complete Medicare Secondary Payor Questionnaire as applicable for retention in Abstracting module
• Calculate patient cost share and be prepared to collect via phone or make payment arrangement
• Contact patient via phone (with as much advance notice as possible, preferably 48 hours prior to date of service) to confirm or obtain missing demographic information, quote/collect patient cost share, and instruct patient on where to present at time of appointment
• Receive and record payments from patient for services scheduled.
• Utilize appropriate communication system to facilitate communication with hospital gatekeeper
• Perform insurance verification and pre-certification follow up for prior day’s walk in admissions/registrations and account status changes by assigned facility
• Communicates with hospital based Case Manager as necessary to ensure prompt resolution of pre-existing, non-covered, and re-certification issues
• Utilize Meditech account notes and Collections System account notes as appropriate to cut and paste benefit and pre-authorization information and to document key information
• Meets/exceeds performance expectations and completes work within the required time frames
• Implements and follows system downtime procedures when necessary
• Practice and adhere to the “Code of Conduct” philosophy and “Mission and Value Statement”
• Other duties as assigned
Qualifications
KNOWLEDGE, SKILLS & ABILITIES
• Communication - communicates clearly and concisely, verbally and in writing
• Customer orientation - establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations
• Interpersonal skills - able to work effectively with other employees, patients and external parties
• PC skills - demonstrates proficiency in PC applications as required
• Policies & Procedures - demonstrates knowledge and understanding of organizational policies, procedures and systems
• Basic skills - able to perform basic mathematical calculations, balance and reconcile figures, punctuate properly, spell correctly and transcribe accurately
EDUCATION
• High school diploma or GED required
EXPERIENCE
• At least three years of insurance verification experience preferred
Parallon