Job Details

Job Type

Full-time

Description

Responsible for obtaining all pre-service documentation from various sources and verifying all the necessary information, such as insurance, diagnosis, and codes, for accuracy. Interview patients to discuss their financial obligations, collect current and past-due money, set up payment plans, and register patients.

• Receive information regarding proposed services via phone, fax, email, or in person.
• Verify insurance benefits with proper diagnosis and procedure codes by:
• Accessing Groupcast, Passport, online insurance verification websites, or any other way possible.
• Contact the insurance companies and governmental payors before the patient's services are scheduled to verify coverage and confirm the patient's responsibility.
• Document findings by keying in the computer system and any applicable forms.
• Counsel patient about coverage and patient responsibility by:
• One-on-one conversation with the patient.
• Phone call to the patient.
• If the patient understands and agrees with patient responsibility and payment arrangements are made, the procedure can be scheduled and documented in the computer system.
• Contact the clinic for any authorization or pre-cert information needed for a claim by:
• Calling or emailing the appropriate office/person at the clinic for authorizations and pre-certifications
• Documents all information on the patient's account in the computer system.
• Pre-register or register the patient:
• Responsible for obtaining all financial, demographic, and medical data for patient billing and creating an account for the patient.
• Schedules patients for the appropriate procedure at the time available and convenient for the patient.
• Assists the pre-admission nurse by ensuring all necessary documentation (i.e., physician orders, consents, precepts) has been obtained from the referring physician's office or another healthcare provider. Documents accordingly.
• In conjunction with the PAT nurse, will interact and coordinate pre-op testing with ancillary departments in or out of the facility.
• Educate the patient on the medication list and other physician preferences.
• Notifies the Surgical Services Director and Patient Access Supervisor of any unusual cases or extenuating circumstances and any changes in the schedule for the following day.
• Interacts professionally with patients, families, and other healthcare team members positively and courteously.
• Provide backup for other departmental positions as needed.
• Maintains a secure environment to protect patient information.
• Performs other duties as assigned by the Patient Access Supervisor and Revenue Cycle Director.
• As an employee of SHOLA, you are responsible for ensuring we comply with all federal and state privacy protection laws and regulations (HIPAA). You must recognize protected health information (PHI) that requires protection, determine when it is permissible to access, use, or disclose PHI, and reduce the risk of impermissible access to, use, or disclosure of PHI.
• Exceptional patient satisfaction is the expected culture at SHOLA. Each employee is responsible for delivering exceptional patient satisfaction in all encounters with patients, families, and visitors. You are responsible for always holding yourself and your peers accountable for providing excellent patient satisfaction.
• As an employee of SHOLA, you are responsible for ensuring we comply with all federal and state privacy protection laws and regulations (HIPAA). You must recognize protected health information (PHI) that requires protection, determine when it is permissible to access, use, or disclose PHI, and reduce the risk of impermissible access to, use, or disclosure of PHI.
• Exceptional patient satisfaction is the expected culture at SHOLA. Each employee is responsible for delivering exceptional patient satisfaction in all encounters with patients, families, and visitors. You are responsible for always holding yourself and your peers accountable for providing excellent patient satisfaction.

The statements mentioned above outline the general duties necessary to describe the essential functions of this position. However, they are not meant to be considered a comprehensive description of all the work requirements that may be inherent in the position.

Requirements

Education: High school education or equivalent with two (2) years of college preferred.

Experience: At least two (2) years of experience in a healthcare scheduling setting is preferred, with additional experience in registration, insurance verification, and extensive customer service skills.

Licenses/Certificates:

Special Skills: At least two (2) years of experience in a healthcare setting, with a preference for healthcare scheduling and additional experience in customer service. Extensive customer service experience in a healthcare setting, preferably scheduling. Must know and decipher medical CPT codes and procedures.

Reports To: Patient Access Supervisor

Positions reporting directly to this position: None