Parallon Business Solutions Richmond Shared Service Center is seeking a Pre-Registration Insurance Verification Rep.
Work hours are Monday - Friday from 10:30am - 7pm.
GENERAL SUMMARY OF DUTIES
Responsible for timely and accurate pre-registration and insurance verification. Accurately interprets managed care contracts and is proficient in the use of the Contrak system.
DUTIES INCLUDE BUT ARE NOT LIMITED TO:
Retrieve reservation/notification of scheduled admission from gatekeeper via laser printer
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, via the use of the Contrak system
Perform electronic eligibility confirmation when applicable and document results
Research Patient Visit History to ensure compliance with the Medicare 72 hour rule
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 rendered.
Utilize Meditech MOX 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-n-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
High school diploma or GED required
At least three years of insurance verification experience preferred