Pre-Registration/Insurace Verification Representative
PAS - Dallas - Irving, TX

This job posting is no longer available on HCA Inc. Find similar jobs:PAS jobs

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 preexisting, 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

Qualifications
KNOWLEDGE, SKILLS & ABILITIES

• Communication - communicates clearly and concisely, verbally and in writing

• Customer orientation - establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations

• Interpersonal skills - able to work effectively with other employees, patients and external parties

• PC skills - demonstrates proficiency in PC applications as required

• Policies & Procedures - demonstrates knowledge and understanding of organizational policies, procedures and systems

• Basic skills - able to perform basic mathematical calculations, balance and reconcile figures, punctuate properly, spell correctly and transcribe accurately

EDUCATION

• High school diploma or GED required

EXPERIENCE

• At least one year of insurance verification experience preferred

Parallon