PreReg/Insurance Verification Representative (PRN) San Antonio Shared Services Center
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POST DATE 8/11/2016
END DATE 10/8/2016
San Antonio, TX
JOB DESCRIPTIONJob Code: 08949-123076
Parallon pioneered the modern-day concept of healthcare shared services more than 12 years ago, perfecting revenue cycle management best practices and customizable technologies for the industry s largest healthcare provider in 700+ facilities and 1000+ physician practices. Today, our team of more than 13,000 revenue cycle professionals applies unmatched expertise, scale and proven processes daily to improve financial performance and long-term sustainability at facilities nationwide.
JOB SUMMARY- Responsible for timely and accurate pre-registration and insurance verification. Accurately interprets managed care contracts.
DUTIES INCLUDE BUT ARE NOT LIMITED TO:
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
Perform electronic eligibility confirmation when applicable and document results
Research Patient Visit History to ensure compliance with payor specific payment window rules
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 scheduled.
Utilize appropriate 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
Utilize Meditech account notes and Collections System account notes as appropriate to cut and paste benefit and pre-authorization information and to document key information
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
HIGH SCHOOL DIPLOMA OR GED REQUIRED
AT LEAST THREE YEARS OF INSURANCE VERIFICATION EXPERIENCE PREFERRED
PARALLON IS AN EQUAL OPPORTUNITY EMPLOYER (EOE), MINORITY/FEMALE/VETERAN/DISABLED, OFFERING A GREAT WORK ENVIRONMENT, CHALLENGING CAREER OPPORTUNITIES, AND COMPETITIVE COMPENSATION.
LACK OF INFORMATION CAN DELAY THE APPLICATION PROCESS, AND THEREFORE APPLICANTS SHOULD BE THOROUGH IN COMPLETING THE ONLINE APPLICATION.
Last Edited: 08/10/2016