Preregistration Specialist

Responsibilities

• Access assignments via work queues to review insurance information registered for accuracy and completeness and places Business Office Review on each account in order to clear cases for surgery.
• Contact insurance carrier and/or reimbursement sources via telephone and/or electronic tools to verify eligibility and obtain all applicable benefits pertaining to services being rendered.
• Provide required clinical and demographic information to payer to obtain the proper authorization/pre-certification for the services being rendered.
• Determine all patient out-of-pocket liabilities and contact patients to coordinate collection of all out-of-pocket liabilities.
• Calculate patient’s remaining balances and refer to the Patient Financial Advocate to finalize the method of resolving the patient liability through point of service collections, payment plans, or other arrangements.
• When applicable, refer to Financial Counseling appropriately when the patient has limited benefits or patient is uninsured.
• Meet on a regular basis with Management and communicate clearly the progress and status of all assigned functions and assist in projects for the department to enhance patient care and quality assurance.
• Exercise complete patient confidentiality in all dealings with patient information and demonstrate an awareness of patient/employee safety when carrying out daily responsibilities of their position.

Qualifications

• H.S. Diploma/GED
• 3-5 years minimum of Pre-certification experience

Skills

• Knowledge of insurance plans and policies
• Ability to verify eligibility and obtain benefits
• Ability to obtain authorization/pre-certification
• Ability to calculate patient out-of-pocket liabilities
• Ability to coordinate patient collections
• Ability to communicate with patients and management
• Confidentiality and safety awareness

Benefits

• Comprehensive compensation and benefits program
• Prepaid tuition assistance program

Pay

• Details about pay not specified

Schedule

• Hybrid schedule