Pre-Arrival Unit Representative

Job Summary

The Pre-Arrival Unit Representative plays a crucial role in ensuring seamless patient care by obtaining necessary authorizations and verifying eligibility and coverage. They communicate with internal and external stakeholders, maintain confidentiality, and contribute to process improvement.

Education & Experience

• High School Diploma/GED and one (1) year of healthcare experience.

Responsibilities

• Verify patient insurance eligibility and coverage.
• Maintain strict confidentiality and adhere to all HIPAA guidelines and regulations.
• Leverage available information (e.g., CPT codes and diagnosis codes) to obtain authorizations.
• Obtain approval for services scheduled by external providers.
• Pre-certify services requiring authorization in a timely and efficient manner.
• Pre-certify outpatient procedures in a timely manner when applicable.
• Complete Notification of Admission (NOA) promptly to notify relevant payers of patient admissions.
• Communicate with patients, insurers, and relevant parties regarding insurance verification and authorization.
• Provide updates and address questions regarding work progress with team members, leadership, and external departments.

Physical and Environmental Demands

• Requires occasional exposure to unpleasant or disagreeable physical environment such as high noise level and exposure to heat and cold.
• Requires occasional handling or working with potentially dangerous equipment.
• Requires occasional working hours beyond regularly scheduled hours.
• Requires occasional travelling to offsite locations.
• No activities subject to significant volume changes of a seasonal/clinical nature.
• Occasional work produced is subject to precise measures of quantity and quality.
• Requires occasional bending.
• Requires occasional lifting/carrying up to 10 pounds.
• Requires occasional lifting/carrying up to 25 pounds.
• Requires occasional lifting/carrying up to 50 pounds.
• Requires occasional lifting/carrying up to 75 pounds.
• Requires occasional lifting/carrying up to 100 pounds.
• No lifting/carrying 100 pounds or more.
• No climbing.
• No crawling.
• Requires occasional crouching/stooping.
• Requires occasional driving.
• Requires occasional kneeling.
• Requires occasional pushing/pulling.
• Requires frequent reaching.
• Requires frequent sitting.
• Requires frequent standing.
• Requires occasional twisting.
• Requires frequent walking.