Employment Type:

Shift:

Description:

Position Purpose:

Saint Alphonsus Health System is hiring a PreService Specialist to support the Regional Scheduling Team. This position is responsible for scheduling patients for services within Saint Alphonsus Health System performing insurance verification and prior authorizations and notifying patients of their appointments prior to services being rendered.

Position Highlights and Benefits:

• Schedule Information: This position will be scheduled for 40 hours a week from 9am to 5:30pm Monday through Friday.
• Hybrid Eligibility:This role will be eligible for hybrid work after an initial training period as designated by the hiring manager.
• Day 1 Benefits for colleagues! Our comprehensive benefit package includes medical vision dental paid time off 403B education assistance and more.

Minimum Qualifications:

• High school diploma or equivalent required.
• Associate degree or an equivalent combination of education and experience preferred but not required. Data entry skills (50-60 keystrokes per minute).
• Past work experience of at least 2 years within healthcare and/or payer environment performing patient access and/or customer service activities is highly desired but not required.

What You Will Do:

• Responsible for pre-registering the patient for upcoming visit(s) by interviewing the patient family member and/or guarantor.
• Validates obtains and enters demographic clinical financial and insurance information into the patient accounting system.
• Utilizes multiple modes of communication (phone fax patient portal/e-mail mail etc.) and in a professional accurate efficient and courteous manner to obtain information and ensure good patient relations and a smooth billing process.
• During pre-registration calls the position will provide information regarding directions parking transportation service overnight accommodations etc. Pre-Registration may be initiated by Scheduling staff with follow-up by the Pre-Service Specialist to ensure data integrity and completeness.
• Performs insurance eligibility/benefit verification utilizing a variety of mechanisms (primarily EDI transactions and payer web access and in some cases by calling payers directly) and documenting information within the patient accounting system. Outcomes of the insurance eligibility/benefit verification activity will determine next steps (designation as a Self-Pay account referral to financial counseling etc.).
• Determines need for appropriate service authorizations (pre-certifications third-party authorizations referrals) and will contact the physician and Case Management/Utilization Review personnel as necessary.
• Informs patient/guarantor of their liabilities and collects appropriate patient liabilities including co-payments co-insurances deductibles deposits and outstanding balances at the point of pre-registration. Calculates patient liabilities and provides financial education referring the patient to financial counseling as required. Documents payments/actions in the patient accounting system and provides the patient with a payment receipt in the collection of funds.
• Validates medical necessity (LCD/NCD review) of Medicare and Non-Medicare cases to ensure clinical and financial clearance. Contacts scheduling and/or ancillary department staff for clarification if cases require clarification of diagnosis and/or test(s)/procedure(s).

Highlights and Benefits:

When Saint Alphonsus takes care of you you can take better care of our patients. We foster personal and professional growth and offer opportunities that empower our colleagues to develop their careers. Our belief in work-life balance compliments the natural beauty diverse landscapes and outdoor recreation lifestyle that is unique to Idaho and Oregon.

• We offer market-competitive pay generous PTO and multiple options for comprehensive benefits that begin on day one.
• Benefits for your future include retirement planning and matching college savings plans for your family and multiple life insurance plans that can change as your needs develop.
• We are proud to offer Employee Assistance Programs tuition reimbursement and educational opportunities to help you learn and grow.

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Ministry/Facility Information:

Saint Alphonsus Health System is a faith-based ministry and not-for-profit health system serving Idaho Oregon and northern Nevada communities. The health system boasts 4 hospitals 609 licensed beds and 73 clinic locations. Through innovative technologies compassionate staff and healing environments Saint Alphonsus goal is to improve the health and well-being of people by emphasizing care that is patient-centered physician-led innovative and community-based.

• Top 15 Health Systems in the country by IBM Watson Health;
• The regions most advanced Trauma Center (Level II);
• Commission on Cancer Accredited Program through demonstrating an uncompromising commitment to improving patient survival and quality of life.

Our Commitment

Rooted in our Mission and Core Values we honor the dignity of every person and recognize the unique perspectives experiences and talents each colleague brings. By finding common ground and embracing our differences we grow stronger together and deliver more compassionate person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race color religion sex sexual orientation gender identity national origin disability veteran status or any other status protected by federal state or local law.