Pre Registration / Insurance Verification Rep

Mô tả công việc

GENERAL SUMMARY OF DUTIES – 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 • 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 and 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