Pre-Services Representative - I - FT - Days - MSS

Responsibilities

• Handles inbound and/or outbound calls to perform all pre-service functions included but not limited to scheduling, authorizations, benefits, and patient responsibilities.
• Documents appropriate record with the details of the call and the call disposition.
• Inputs and/or reviews insurance benefits for the patient account.
• Re-runs estimates when needed to correct expected patient out-of-pocket liability for that service.
• Updates patient insurance information into the patient record as needed to ensure correct billing and net revenue estimation occurs.
• Confirms insurance coverage.
• Determines necessity for pre-authorization and obtains authorization for that service(s).
• Documents authorization information within the patient account.
• Reviews order for appropriate authorizing signature and accuracy of scheduled service(s).
• Communicates with patients and practitioners regarding order, insurance and/or authorization issues.
• Notifies patient of their financial responsibility for services to be provided.
• Educates guarantor about their out of pocket responsibility for the service and collects pre-service payments in accordance with available financial options.
• Ensures compliance with departmental procedures for payment.

Qualifications

• High School Diploma or Equivalent (Required)

Skills

• ACCOUNTABILITY
• ACCURACY
• CUSTOMER SERVICE
• EFFECTIVE COMMUNICATION
• ORGANIZATION SKILLS
• PATIENT AND FAMILY CENTERED CARE
• PROBLEM SOLVING
• PRODUCTIVITY
• RESPONDING TO CHANGE
• STANDARDS OF BEHAVIOR
• TEAM WORK

Benefits

Not specified

Schedule

Not specified

Pay

Not specified