Job Description
RESPONSIBILITIES:
• Conducts scheduling, and preregistration functions, validates patient demographic data, identifies and verifies medical benefits, accurate plan code and COB order.
• Obtains limited clinical data based on service required.
• Corrects and updates all necessary data to assure timely, accurate bill submission.
• Verifies insurance information through payor contacts via telephone, online resources, or electronic verification system. Identifies payor authorization/referral requirements.
• Provides appropriate documentation and follow up to physician offices, case management department, and payors regarding authorization/referral deficiencies.
• Identifies all patient financial responsibilities, calculates estimates, collects liabilities and post payment transactions as appropriate in the ADT system and performs daily reconciliation.
• Identifies self-pay and complex liability calculations and escalates account to Financial Counselors as appropriate.
• Delivers positive patient experience. Cooperates with and maintains excellent working relationships with patients, leadership and staff, physician offices and designated external agencies or vendors.
• Performs any written or verbal communication necessary to exchange information with designated contacts and promote working relationships.
• Maintains focus on attaining productivity standards, recommending innovative approaches for enhancing performance and productivity when appropriate.
• Adheres to organizational policies and procedures for relevant location and job scope. Completes and/or attends mandatory training and education sessions within approved organizational guidelines and timeframes.
QUALIFICATIONS:
• Minimum High school diploma or GED; or one – three months related experience and/or training; or equivalent combination of education and experience.
• One previous year of related experience, preferably within a medical setting, financial services setting, and/or a demanding customer service environment.
• Experience operating a PC and using software applications.
• Medical terminology and obtaining insurance verifications (Preferred).
• Call/Service Center experience (Preferred).
• Conducts scheduling, and preregistration functions, validates patient demographic data, identifies and verifies medical benefits, accurate plan code and COB order.
• Obtains limited clinical data based on service required.
• Corrects and updates all necessary data to assure timely, accurate bill submission.
• Verifies insurance information through payor contacts via telephone, online resources, or electronic verification system. Identifies payor authorization/referral requirements.
• Provides appropriate documentation and follow up to physician offices, case management department, and payors regarding authorization/referral deficiencies.
• Identifies all patient financial responsibilities, calculates estimates, collects liabilities and post payment transactions as appropriate in the ADT system and performs daily reconciliation.
• Identifies self-pay and complex liability calculations and escalates account to Financial Counselors as appropriate.
• Delivers positive patient experience. Cooperates with and maintains excellent working relationships with patients, leadership and staff, physician offices and designated external agencies or vendors.
• Performs any written or verbal communication necessary to exchange information with designated contacts and promote working relationships.
• Maintains focus on attaining productivity standards, recommending innovative approaches for enhancing performance and productivity when appropriate.
• Adheres to organizational policies and procedures for relevant location and job scope. Completes and/or attends mandatory training and education sessions within approved organizational guidelines and timeframes.
QUALIFICATIONS:
• Minimum High school diploma or GED; or one – three months related experience and/or training; or equivalent combination of education and experience.
• One previous year of related experience, preferably within a medical setting, financial services setting, and/or a demanding customer service environment.
• Experience operating a PC and using software applications.
• Medical terminology and obtaining insurance verifications (Preferred).
• Call/Service Center experience (Preferred).
Additional Details
Experience: 0-2 years