Pre-Service Representative- Remote

Job Duties

• Prepares, validates and completes all steps necessary to clear new cases for pre-scheduled services.
  • This includes, but is not limited, to validating and gathering insurance and demographic information.
    • Interacts with insurance companies via, website, phone, or fax to verify benefits, obtain authorizations, identify insurance guidelines, and facilitate communication.
      • Gathers information to verify benefits and benefits eligibility by utilizing the EPIC system.
        • Completes and obtains all necessary authorizations for the service(s) to be performed.
          • Works with the clinical providers, on-site case management team, as well as LPN/RN or Nurse Auditor in the Pre-Service department.
            • Performs Pre-Service collection estimation functions and communicates patient liability.
              • Provides point-of-service information and logistics to ensure an exceptional patient experience.
              • Other related duties as required.

Requirements

• Education Required – High School diploma or equivalent
  • Work Experience Preferred – Associates Degree or Bachelor Degree Required – 1 year related experience in related hospital, clinic, medical office, business services/revenue cycle, front line registration, financial counseling, banking and/or customer service related job
    • Preferred – Experience With EPIC Knowledge

Skills and Abilities (KSAs)

• Must have computer skills and dexterity required for data entry and retrieval of patient information.
  • Effective verbal and written communication skills and the ability to present information clearly and professionally to varying levels of individuals throughout the patient care process.
    • Proficient with Windows-style applications, keyboard, and various software packages specific to role.
      • Strong interpersonal skills.
        • Ability to multi-task.
          • Ability to perform effectively in a fast-paced ever-changing environment.
            • Ability to remain calm and professional in high-pressure/stressful situations regarding patient financial and medical conversations.

Physical and Environmental Demands

• Light Work - Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly (Constantly: activity or condition exists 2/3 or more of the time) to move objects.
  • Physical demand requirements are in excess of those for Sedentary Work.
    • Even though the weight lifted may be only a negligible amount, a job should be rated Light Work: (1) when it requires walking or standing to a significant degree; or (2) when it requires sitting most of the time but entails pushing and/or pulling of arm or leg controls; and/or (3) when the job requires working at a production rate pace entailing the constant pushing and/or pulling of materials even though the weight of those materials is negligible.
      • Note: The constant stress and strain of maintaining a production rate pace, especially in an industrial setting, can be and is physically demanding of a worker even though the amount of force exerted is negligible.
        • Normal routine involves no exposure to blood, body fluid or tissue and as part of their employment, incumbents are not called upon to perform or assist in emergency care or first aid.
          • The incumbent has no occupational risk for exposure to hazardous medications or hazardous waste within the environment through receipt, transport, storage, preparation, dispensing, administration, cleaning and/or disposal of contaminated waste.
            • The risk level of exposure may increase depending on the essential job duties of the role.