Preservice Specialist I Full Time

Full Time: Monday-Friday 8:30am-5:00pm. Hybrid-Remote.

Northwell is the largest not-for-profit health system in the Northeast serving residents of New York and Connecticut with 28 hospitals more than 1000 outpatient facilities 22000 nurses and over 20000 physicians. Northwell cares for more than three million people annually in the New York metro area including Long Island the Hudson Valley Connecticut and beyond thanks to philanthropic support from our communities. Northwell is New York States largest private employer with over 104000 employees including members of Northwell Health Physician Partners who are working to change health care for the better

Summary:

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 pre-registration functions and insurance eligibility verification. Provides estimates for services. Requests and secures payments.

Responsibilities:

be assigned to schedule patients for hospital or medical group services by incoming phone calls online requests or outbound to patients. 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 in-system retention of patients and continuity of care. 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 pre-certifications 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.6. Contacts patients to perform pre-registration 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.7. Safeguards patient confidentiality by adhering to all department organization state and federal compliance guidelines. Fulfills all compliance responsibilities related to the position. 8. Performs other duties as assigned.

Education Skills Experience:

HS Diploma Required. Minimum of 2-year job-related experience National Association of Healthcare Access Management (NAHAM) certification within one year of hire Basic MS Word & MS Excel. Customer service and organizational skills. Associates Degree Preferred with 6 months job-related experience - Preferred.

Company: Nuvance Health
Org Unit: 2071
Department: Corporate Financial Clearance
Exempt: No
Salary Range: $19.00 - $26.00 Hourly