Pre-registration/Insurance Verification Representative - Parallon

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POST DATE 9/13/2016
END DATE 11/1/2016

HCA Healthcare Las Vegas, NV

Company
HCA Healthcare
Job Classification
Full Time
Company Ref #
08591-124187
AJE Ref #
576162958
Location
Las Vegas, NV
Experience
Mid-Career (2 - 15 years)
Job Type
Regular
Education
High School Diploma or GED

JOB DESCRIPTION

APPLY
Job Code: 08591-124187

Full-time

No Weekends

***ONLY APPLICANTS WHO INCLUDE SALARY REQUIREMENTS WILL RECEIVE FULL CONSIDERATION


JOB TITLE: Pre-registration/Insurance Verification Representative

GENERAL SUMMARY OF DUTIES Responsible for timely and accurate pre-registration and insurance verification. Accurately interprets managed care contracts and is proficient in the use of the Contrak system.

SUPERVISOR Lead Pre-registration/Insurance Verification Representative

SUPERVISES N/A

DUTIES INCLUDE BUT ARE NOT LIMITED TO:

* Retrieve reservation/notification of scheduled admission from gatekeeper via laser printer

* Perform pre-registration and insurance verification within 24 hours of receipt of reservation/notification for both inpatient and outpatient services

* Follow scripted benefits verification and pre-certification format in Meditech custom benefits screen and record benefits and pre-certification information therein

* Contact physician to resolve issues regarding prior authorization or referral forms

* Assign Iplans accurately, via the use of the Contrak system

* Perform electronic eligibility confirmation when applicable and document results

* Research Patient Visit History to ensure compliance with the Medicare 72 hour rule

* Complete Medicare Secondary Payor Questionnaire as applicable for retention in Abstracting module

* Calculate patient cost share and be prepared to collect via phone or make payment arrangement

* Contact patient via phone (with as much advance notice as possible, preferably 48 hours prior to date of service) to confirm or obtain missing demographic information, quote/collect patient cost share, and instruct patient on where to present at time of appointment

* Receive and record payments from patient for services rendered.

* Utilize Meditech MOX communication system to facilitate communication with hospital gatekeeper

* Perform insurance verification and pre-certification follow up for prior day s walk in admissions/registrations and account status changes by assigned facility

* Communicates with hospital based Case Manager as necessary to ensure prompt resolution of pre-existing, non-covered, and re-certification issues

* Utilize Meditech account notes and Collections System account notes as appropriate to cut-n-paste benefit and pre-authorization information and to document key information

* Meets/exceeds performance expectations and completes work within the required time frames

* Implements and follows system downtime procedures when necessary

* Practice and adhere to the Code of Conduct philosophy and Mission and Value Statement

* Other duties as assigned

KNOWLEDGE, SKILLS & ABILITIES

* Communication - communicates clearly and concisely, verbally and in writing

* Customer orientation - establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations

* Interpersonal skills - able to work effectively with other employees, patients and external parties

* PC skills - demonstrates proficiency in PC applications as required

* Policies & Procedures - demonstrates knowledge and understanding of organizational policies, procedures and systems

* Basic skills - able to perform basic mathematical calculations, balance and reconcile figures, punctuate properly, spell correctly and transcribe accurately

EDUCATION

* High school diploma or GED required

EXPERIENCE

* At least three years of insurance verification experience preferred


CERTIFICATE/LICENSE - N/A

Last Edited: 09/12/2016