Advanced Inpatient Presvc Spec

Job Details

Title: Advanced Inpatient Presvc Spec

Department Org: Registration - 108820

Employee Classification: B1 - Classif'd Full Time AFSCME HSC

Bargaining Unit: AFSCME HSC

Primary Location: HSC H

Shift: 1

Start Time: 4:30AM End Time: 5:00PM

Float: Yes

Rotate: Yes

On Call: Yes

Travel: Yes

Weekend/Holiday: Yes

Job Description:

The Advanced Inpatient Preservice Specialist performs all scheduling, pre-registration and insurance verification for inpatient surgery, imaging care, advanced diagnostic testing, infusion services, and other non-routine inpatient care services. Performs complete and accurate patient appointment scheduling, account pre-registration, insurance verification and authorization functions either via electronic media collection or telephonic interview methods; works to provide patient information which maximizes reimbursement, achieves collection ratios, meets accounts receivable (AR) goals, and provides timely and through information to all other providers and users of patient data. Verifies insurance requirements, obtains and understands insurance benefits, obtains prior authorizations and care certifications as required by applicable payors. Requests any non-covered patient collectibles such as coinsurance, deductibles, and copayments prior to service; Ensures that patients meet financial requirements and that insurance authorization requirements are met prior to services being rendered; Provides general information to hospital users, patients and families; Communicates effectively to service delivery areas to maximize patient flow and customer service outcomes both internally and externally.

Minimum Qualifications:

1. High school graduate or equivalent required.
2. 1 year experience with ICD-9 and/or CPT codes required.
3. Medical practice insurance and coding diploma, Registered Health Information Technician, Certified Healthcare Access Associate, Certified Revenue Cycle Representative, Licensed Practice Nurse, or like designation preferred.
4. Two years current professional office experience in medical collections, billing, medical insurance verification and precertification, advanced patient scheduling or equivalent education preferred.
5. 40wpm typing speed required.
6. Experience in internet, internet navigation, word processing, standard computer manipulation required
7. Ability to calculate fractions, decimals and percentages and to read and write common vocabulary required.
8. Ability to work with minimum supervision.
9. Excellent communication skills, oral and written skills.
10. Ability to deal with confrontation.
11. Ability to develop and maintain professional, service oriented working relationships with patients, families, physicians, nurses, co-workers, supervisors and others.
12. Must be able to understand and comply with policies and procedures.
13. Possess excellent analytical and problem solving skills and perform multiple tasks while working independently.
14. Ability to work collaboratively with a high performance team of professionals in partnership toward common objectives
15. Knowledge of information systems and healthcare applications.
16. Proficient in Word and Excel, required.
17. Work in a professional office environment with possible high stress levels
18. Previous customer service experience required.