Pre-Service Financial Clearance

QUALIFICATIONS

      Education

• High school diploma or equivalent
• Associate degree preferred

      Experience/Skills

• Has one year patient access, medical billing, or prior authorization experience
• Possesses medical terminology and CPT/HCPCS/ICD-10 coding knowledge
• Demonstrates proficiency in Meditech and MS Excel
• Professionally collaborates with staff at various levels throughout the organization, including, but not limited to: Physician Practices, HIM, Information Systems, Patient Financial Services and Clinical Directors
• Works efficiently with minimal supervision
• Remains flexible to accommodate staffing shortages in the Patient Access department

      Required Licenses/Certifications

      Working Conditions

• Works in a well-ventilated, well-lit general office environment
• Works well under pressure with attention to time constraints

ROUTINE RESPONSIBILITIES

      Behavioral Expectations

      Essential Duties

• Calls patient prior to service to verify demographics and insurance, and notifies of copay amount that is expected at time of service
• Verifies insurance eligibility and benefits directly with payer or on payer Website prior to scheduled appointment
• Pre-registers patient in Meditech and ensures billing information matches in Athena for clinical staff
• Prints face sheet and labels
• Documents when unable to reach patient prior to visit so that department secretary can verify demographic information at time of service
• Indicates copay amount due on the face sheet sent over to office
• Educates insured patient on their insurance benefits payment obligations and installment requirements prior to services
• Documents all information obtained during pre-registration activities
• Identifies uninsured, underinsured and low-income patients
• Refers uninsured, underinsured, and low-income patients to Financial Counselors for financial assistance options and other arrangements prior to patient visit
• Collaborates with Patient Account Reps and Front Desk staff before patient is seen to prevent avoidable write-offs