PRE-REG PRE-CERT SPECIALIST
I am at least 18 years of age
I am authorized to work in the United States
I meet the job requirements as described
Work among the best. We are a top 25 employer in the metro area offering a wide array of career opportunities within our organization. We have a leading reputation for patient care, medical education, research, and community service. We value and respect the talented, committed, and diverse people who make up our hospital; they are our most important strength. The hospital offers very competitive wages and an outstanding benefit package.
We currently have an opening for Pre-Registration/Pre-Certification Specialist
* Works reports daily according to duty specifications to retrieve all un-contacted patients prior to service. Utilizes worklists to pre-register / pre-certify hospital services.
* Identifies patients who qualify for pre-registration to include all new patients and all return patients. Identifies any patient with financial needs and refers directly to a Patient Financial Advisor.
* Conducts telephone interview with patients to elicit demographic information and third party payor data that will be needed for billing purposes.
* Enters patient data directly into registration systems. Ensures that MSPQ is completed when appropriate.
* Verifies with third party payor dependent eligibility, certificate and group numbers, co-payment and deductible amounts, statement mailing address, etc. Complies with Medicare / Medicaid and other insurance rules and regulations.
* Works closely with the clinics, hospital ancillary departments, pre-certification specialists and patient financial advisors in regards to potential complications regarding insurance coverage.
* Updates and changes insurance or demographic information on an as-needed basis.
* Adheres to corporate compliance standards.
* Provides assistance with initial and ongoing training of staff.
* Insurance Verification and Pre-certification
* The employee is responsible for verification and pre-certification, notification and authorization of all admissions and / or outpatient visits.
* Responsible for pre-service collections and EPIC documentation when applicable.
* For all sponsored admissions, the employee will contact patients' employer and/or insurance company to verify coverage and benefits, obtain benefit level, patient liability, billing address. The employee will obtain pre-certification and/or authorization if needed. Contact agency, if necessary, for authorization of payment.
* The employee will take actions, which lead to the account being secured per established departmental policy. This includes but is not limited to, contacting the patient, contacting responsible payers including government and non-government payers, contacting the patient's employer, referring uninsured and underinsured accounts to the Financial Advisors, and taking any other necessary actions. Contact provider office immediately of any restrictions denying services, such as inability to obtain pre-certification or any lock-in program by any agency.
* Responsible for other duties or projects which are assigned by Management. These may include special projects, telephone coverage, filing, copying and other duties as instructed.
* High School Diploma or equivalent required
* Three to five years of experience in registration functions / pre-certification / customer service in a Health Care setting preferred
* Basic computer skills required
* Ability to maintain confidentiality with patient information
* Ability to maintain harmonious relationships within the work team, in the department and outside the department
* Ability to communicate clearly, use good judgement and be sympathetic toward patients
* Ability to work under stress with frequent interruptions
*** If selected to move forward in the hiring process, you will receive an email invitation to schedule your interview for this position. Please continue to check your email after you have submitted your complete application online.
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The University of Kansas Medical Center is committed to providing an equal opportunity for all qualified individuals to be considered for employment, benefits and conditions of employment, and to participate in or benefit from education programs and activities, regardless of race, religion, color, ethnicity, sex, disability, national origin, ancestry, age, status as a veteran, sexual orientation, marital status, parental status, gender identity, gender expression, or genetic information. A university community that provides equal opportunity for all will make significant strides towards the elimination of discrimination.
It is the mission of the Equal Opportunity Office to create a community of equality and inclusiveness that provides full and fair opportunities for all persons and to foster an intellectually and culturally diverse environment of learning and leadership where all individuals are valued, respected, and unhindered in their pursuit of excellence in their work and education.