Preservice Specialist II
Preservice Specialist II
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Job Description
Description
Summary:
Responsible for all accountabilities of the PreService Specialist 1. Facilitates patient flow through the referral scheduling and financial clearance process. Responsible for obtaining demographic and financial information to ensure accurate patient identification and to secure reimbursement. Performs preregistration functions and insurance eligibility verification. Provides estimates for services. Requests and secures payments.
Responsibilities:
1. Performs all responsibilities of the PreService Specialist 1 position. May provide functional guidance to PreService Specialist 1 employees. 2. Assists new employees to the department by shadowing providing guidance sharing knowledge and training on department policies workflows and procedures. fully cross trained to either schedule or financially clear all modalities that the team is responsible for. be assigned to schedule patients for hospital or medical group services by incoming phone calls online requests or outbound to patients. 5. May be assigned to work within the central referral management system to identify and schedule specialist and primary care referrals to NHMP practices as well as external providers when appropriate with the goal of promoting insystem retention of patients and continuity of care. 6. Provides excellent customer service both to physician offices and patients. Contributes to reduction of abandoned call rate length of calls and average speed answered through use of best practices and workflow improvements as defined by management. Receives incoming faxed physician orders. Verifies orders for compliance and accuracy. insurance eligibility verification and executes payer requirements as needed. Obtains accurate insurance benefit information from payers such as deductible copay and coinsurance amounts. Utilizes patient estimation tool to calculate estimate of patient liabilities. Requires an understanding of coding procedural protocols and the charge description master. requests for authorizations precertifications notices of admission and referrals from insurance companies. Follows up with payers and providers to ensure that authorizations are in place. Takes appropriate steps to remediate situations in which financial clearance is not completed to ensure that Nuvance Health receives prompt payment for services rendered. patients to perform preregistration including demographic verification conveyance of insurance benefits and estimates of liabilities. Collects on such liabilities prior to time of service utilizing provided scripting. Refers patients who express financial hardship to Financial Counseling for a financial assessment. patient confidentiality by adhering to all department organization state and federal compliance guidelines. Fulfills all compliance responsibilities related to the position. other duties as assigned.
Other Information:
HS Diploma with minimum of 2 years job related experience. Associate degree with 1 years jobrelated experience Preferred. Bachelors Level Degree with a minimum of 1 year job related experience preferred. Basic MS Word & MS Excel. Customer service and organizational skills required. Criteria Desired: National Association of Healthcare Access Management (NAHAM) certification within one year of hire.
Working Conditions:
Manual: significant manual skills/motor coord & finger dexterity
Occupational: Little or no potential for occupational risk
Physical Effort: Sedentary/light effort. May exert up to 10 lbs. force
Physical Environment: Generally pleasant working conditions
Company: Danbury Hospital
Org Unit: 270
Department: Contact Center
Exempt: No
Salary Range: $18.97 $35.21 Hourly
Required Experience:
Unclear Seniority
Employment Type
Full Time
