Pre-Registration Representative - Pre-Registration HSD - FT - Day

Duties

• Schedules patients for hospital services based upon physician orders.
• Cancels and reschedules appointments as needed.
• Works with service departments to coordinate the scheduling of urgent same-day add-ons.
• Completes insurance verification which includes determining in or out of network status, verifying insurance eligibility and benefits with the payer, coordinating multiple insurance coverages, identifying insurance coverage when needed and all other activities relating to the review of insurance.
• Completes the preregistration of scheduled patients via phone by collecting patient demographics, insurance information, accident information, and verifying insurance coverage with payer, educating patient on when and where to arrive for service and any rules related to arrival.
• Completes prior authorizations for identified services. Includes review of medical policies to ensure all criteria is met, the process of completing the prior authorization with the payer and the documentation of prior authorization numbers for inclusion on the claim.
• Completes precertification (or “Notice of Admission”) for inpatient and identified outpatient admissions with payers after patient arrival. Includes entry of received information into the electronic record for downstream processes.
• Creates estimates for identified services within appropriate timeframes. This includes providing financial education to the patient on anticipated balances and the collection of anticipated balances.
• Mentors, orients and provides at-the-elbow training for new staff.
• Prepares paper and electronic documents for scanning into Epic.
• Answers benefits and eligibility questions from patients, office staff, Case Management, Social Work or any other source.
• Reviews incoming faxes and distributes to appropriate departments within the organization.
• When requested, reviews standard work and training materials for clarity and accuracy.
• Participates in process improvement activities.

Qualifications

• High School Diploma / GED Required
• Associate's Degree Preferred
• 2 years Physician office, hospital or payer setting with experience relating to patient registration, patient scheduling, exam or procedure scheduling, prior authorization completion or insurance verification.

Skills

• Knowledge of medical terminology (Required proficiency)
• Knowledge of MicroSoft Windows applications (Preferred proficiency)
• Excellent customer service skills (Preferred proficiency)
• Excellent interpersonal & communication skills with the ability to exhibit patience. (Preferred proficiency)
• Ability to prioritize and handle multiple tasks (Preferred proficiency)

Benefits

Carrying: Rarely less than 1 hour
Eye/Hand/Foot Coordination: Frequently 3-5 Hours
Hearing: Continuously greater than 5 hours
Reaching (Forward): Rarely less than 1 hour
Repetitive Motions: Continuously greater than 5 hours
Sitting: Continuously greater than 5 hours
Standing: Rarely less than 1 hour
Talking: Continuously greater than 5 hours

Pay

Not specified

Schedule

First Shift (Days - Less than 12 hours per shift)