Description
Summary of Position:
Analyzes patient's ability to pay through verification of insurance. Pre-authorizes procedures and surgeries for facility and physician. Updates patient registration and completes/updates forms as needed. Completes other scheduling functions as needed.
Qualifications
Education:
● High School Diploma or GED preferred
Experience:
● Minimum two years previous office administrative/clerical experience preferred.
● Requires detailed knowledge of medical office processes preferred
● Completion of Medical Terminology course, or willingness to complete course within 6 months, or sufficient previous one year experience in a healthcare environment to enable incumbent to be able to read and understand common medical terms required.
Knowledge/Skills/Abilities:
● Must be advanced computer typing and literacy.
● Reading and writing skills, organizing and filing, professional phone etiquette, and strong customer service skills.
● Knowledge of healthcare insurance preferred
● Demonstrates organizational and communication/customer service skills.
● Requires critical thinking skills, decisive judgement and the ability to work with minimal supervision. Must be able to work in a stressful, high paced environment and can take the appropriate action.
● In compliance with patient safety standards, must be able to effectively communicate in English; Bilingual abilities preferred.
Certifications/Licensure:
● N/A
Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
● While performing the duties of this job, the employee is frequently required to walk, stand, sit, and talk or hear.
● The employee is occasionally required to use hands to finger, handle, feel or operate objects, tools, or controls; and reach with hands and arms.
● The employee is occasionally required to climb or balance; stoop, kneel, crouch, or crawl.
● Specific vision abilities required by this job include close vision, color vision, and the ability to adjust focus.
● The employee must occasionally lift and/or move up to 25 pounds.
Working Conditions
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
● Normal office environment. The noise level in the work environment is usually quiet to moderate while in the office.
● Occasional travel to various health system locations.
Essential Functions
1. Provides consistently exceptional care at all times.
2. Ability to prioritize, multi-task and handle emergent situations and critical deadlines.
3. Answers phones, routes callers, takes messages, provides routine information to callers, and returns calls promptly.
4. Exercises judgment as to the urgency and nature of calls and ensures that all messages are relayed to the appropriate staff promptly and communicates problems as they arise through proper channels.
5. Interviews patient and/or guarantor to obtain complete and accurate demographic/financial information to determine patient's ability to pay for services.
6. Screens Self-Pay and underinsured patients to determine their financial needs, referring patient to appropriate department for government assistance or Financial Assistance program.
7. Run cost estimates for applicable services, effectively explain estimates and insurance benefits to patients and request prepayment for upcoming surgeries and/or procedures.
8. Verifies medical necessity of Medicare patients using current online software.
9. Contacts insurance company to obtain benefits, eligibility and any necessary authorizations.
10. Works closely with providers in offices in order to obtain valid authorization for services.
11. Manages referral list and accurately updates referrals.
12. Effectively explains cost estimates, insurance benefits, and advanced beneficiary notices to patients.
13. Effectively collects payments and posts them into cash drawer.
14.Faxes appropriate documentation to insurance companies to assure timely response.
15.Coordinates with other Barton departments to schedule patients (i.e.-surgical, inpatient and hospital follow up appointments).
16. Coordinates multiple appointments in order to offer consecutively scheduled services.
17. Timely corrects registration errors in AhiQa.
18. Communicates problems as they arise through proper channels.
19. Performs assigned clerical duties in an accurate and timely manner such as faxing, photocopying, typing, computer data entry and retrieval.
20.Proficient in the use of the all hospital associated software used to complete tasks.
21. Responds to the needs of the department by performing other duties, as necessary.
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