PreService Scheduling Specialist Part-Time Days - HYBRID

Employment Type: Part time, Day Shift

About the Role

Saint Alphonsus Health System is hiring a PreService Specialist to support the Regional Scheduling Team. This position is responsible for scheduling patients for services within Saint Alphonsus Health System, performing insurance verification and prior authorizations, and notifying patients of their appointments prior to services being rendered. Training will be on-site for at least 3 months; it will be the decision of the Manager when new colleagues are ready to begin working a hybrid schedule.

Schedule

This position will be scheduled for 20 hours a week. Work schedule is flexible; office hours are 9:30 AM to 6:00 PM, Monday through Friday. New team members can choose to work:

• Two 8-hour days + one 4-hour day per week
• Five 4-hour days per week

This role will be eligible for hybrid work after an initial training period as designated by the hiring manager.

Benefits

Day 1 benefits for colleagues! Our comprehensive benefit package includes:

• Medical, vision, and dental insurance
• Paid time off
• 403B retirement plan
• Education assistance
• Retirement planning and matching
• College savings plans for your family
• Multiple life insurance plans
• Employee Assistance Programs
• Tuition reimbursement and educational opportunities

We offer market-competitive pay, generous PTO, and opportunities for personal and professional growth.

Requirements

• High school diploma or equivalent required
• Associate degree or an equivalent combination of education and experience preferred but not required
• Data entry skills (50-60 keystrokes per minute)
• Past work experience of at least 2 years within healthcare and/or payer environment performing patient access and/or customer service activities is highly desired but not required

Responsibilities

• Pre-register patients for upcoming visits by interviewing the patient, family member, and/or guarantor
• Validate, obtain, and enter demographic, clinical, financial, and insurance information into the patient accounting system
• Utilize multiple modes of communication (phone, fax, patient portal/e-mail, mail) to obtain information and ensure good patient relations and a smooth billing process
• Provide information regarding directions, parking, transportation services, and overnight accommodations during pre-registration calls
• Perform insurance eligibility/benefit verification using EDI transactions, payer web access, or direct calls to payers, and document information within the patient accounting system
• Determine next steps based on insurance eligibility/benefit verification (e.g., designation as a Self-Pay account, referral to financial counseling)
• Determine need for appropriate service authorizations (pre-certifications, third-party authorizations, referrals) and contact the physician and Case Management/Utilization Review personnel as necessary
• Inform patient/guarantor of their liabilities and collect appropriate patient liabilities, including co-payments, co-insurances, deductibles, deposits, and outstanding balances at the point of pre-registration
• Calculate patient liabilities, provide financial education, and refer patients to financial counseling as required
• Document payments/actions in the patient accounting system and provide the patient with a payment receipt
• Validate medical necessity (LCD/NCD review) of Medicare and Non-Medicare cases to ensure clinical and financial clearance
• Contact scheduling and/or ancillary department staff for clarification if cases require clarification of diagnosis and/or test(s)/procedure(s)