Pre Services Representative - Concord Hospital Laconia | Full Time | Days
Concord Hospital Health System · Laconia, NH · 3 days ago
OTHRFull-time
Responsibilities
- Performs insurance authorization for elective outpatient radiology imaging and cardiovascular testing.
- Schedules, reschedules and cancels appointments and enters data into Schapptbook according to program logic and Scheduling Guidelines.
- Handles phone calls in a professional and efficient manner adhering to department call standards for Pre Services.
- Using appropriate schedules and work lists verifies insurance benefits and approvals for outpatient imaging, elective procedures and surgical cases and urgent/emergent admissions.
- Notifies Payers of patient admissions/placed in observation as required by payers.
- Manages Faxes received in the Work Queue Monitor Program.
- Communicates and responds to patients, provider(s), payers and other associates/business partners and joint ventures using available tools (Message Center in PowerChart, email/secure email or phones) to ensure accurate scheduling of appointments and billing of encounters.
- Researches and responds to requests for cost of care.
Requirements
- Must have prior knowledge and expertise in insurance policies and coverage and medical necessity and prior authorization requirements.
- Minimum of three years experience in a healthcare or related environment also required.
- Working knowledge of medical terminology, Microsoft Office applications and the ability to navigate in a Windows based environment.
- Must have proven exceptional communication skills, critical thinking and problem solving skills, and interpersonal skills.
Qualifications
High school diploma or equivalent (GED).
Skills
Prior knowledge and expertise in insurance policies and coverage and medical necessity and prior authorization requirements.
Benefits
N/A
Pay
N/A
Schedule
Full time 40 hours/week Monday through Friday 7:30 am - 4:00 pm
About the Role
The Pre Services Representative is engaged in one or more of the revenue cycle roles including: pre-service scheduling and patient access, pre-registration, insurance verification, financial clearance and denial management.