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Description
- Verifies insurance benefits
- Processes accounts to ensure that patients are preregistered and required insurance authorization and precertification’s are obtained prior to the date of service.
- Communicates with patients and insurance companies regarding coverage and other related matters. Discusses benefits with patients, responds to patient/third party inquiries.
- Completes insurance verification /pre-certification according to payor requirements: Identifies outpatient procedures that require precertification /second opinion: obtains required information from physician; pre-certifies inpatient admissions.
- Works with financial counselor to request pre-payment and informs patients of discounts
- Completes Medicare Questionnaire; ensures that medical necessity is established for Medicare / Medicaid patients
- Responsible for accurately scheduling diagnostic and/or surgical procedures
- Conducts physician office/patient interviews and explains hospital procedure guidelines and policies
- Responsible for obtaining complete and accurate clinical, demographic and financial information during the scheduling process
- Provides the patient with prep and other appointment instructions
- Follows guidelines for special requires /STAT/schedule modification procedures and coordinates communications with clinical areas to accommodate the patient requests
- Notifies patient of physician order, preauthorization and other financial clearance requirements
- Other duties as assignedÂ
Requirements
Education/Experience:
- High school graduate or equivalentÂ
- Prior medical experience and knowledge of insurance policies and procedures preferred
- Medical terminology preferred
Skills/Abilities:
- Excellent communication and interpersonal skills required to discuss financial matters with patients and/or their representative, and to work with all levels of professionals at JCH and in other organizations.
- Ability to comprehend large amounts of complex information, and explain complex insurance benefits to patients and/or their representatives.
- Ability to respond to quickly changing priorities and patient needs
- Demonstrated computer skills and related experience preferred
Physical Requirements:
- Work is of light demand
- Motor coordination and finger dexterity required to operate computer equipment and other office machines
Benefits:
- Health Insurance
- Dental Insurance
- Vision Insurance
- Life Insurance
- Retirement
- Paid Time Off
- Tuition Reimbursement
- Health Savings Account
- Wellness Program
- Employee Assistance Program
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