Insurance & Pre-Registration Rep, FT, Days
Inspire health. Serve with compassion. Be the difference.
Job Summary
Verifies insurance coverage/benefits and current patient responsibility utilizing online eligibility, websites or telephone inquiry to the insurance administrator and/or third-party payor and ensures insurance is listed accurately and completely. Initiates, obtains, and documents pre-certification/prior authorizations as required according to Departmental Guidelines.
Accountabilities
• Contacts patient or other source (in accordance with HIPPA Guidelines) to secure information relative to financial status, demographic data and employment information. Enters accurate information into GE patient billing system, access onBase to ensure most recent insurance card is on file, and scans other documents as necessary. Follows up for incomplete and missing information. 50%
• Verifies insurance coverage/benefits utilizing online eligibility, websites or by telephone inquiry to the employer and/or third party payor. Information obtained through insurance verification must always be documented in the GE patient billing system. Assigns appropriate FSC (financial classification) ; ensures insurance priorities are correct based on third-party requirements/ COB. 15%
• Initiates pre-certification process as required according to Departmental Guidelines; makes patients aware of need for signed waiver for cases where pre-certification is required but not yet obtained. Will work in conjunction with the UMG practices to make sure this document is signed and copy retained. 10%
• Alerts patients to necessary signatures and other information on appropriate forms and documents as required including, but not limited to, Consent Form, Liability Assignment, Waiver Letter. Documents should be scanned according to Departmental Guidelines. 5%
• Receives payments and issues receipts. Maintains cash funds/verification logs and makes daily deposits according to departmental policies and procedures. 10%
• Alerts patients to documents that will need to be signed in the practice. This includes, but is not limited to, GHS Privacy Notice, Patient Rights and Responsibilities, Patient Rights in Healthcare Decisions Brochure, Medicare Booklet. 5%
• Communicates patients estimated financial responsibility utilizing UMG Patient Portion Pricer and requests payment prior to or at the time of service; Patients who may need extended terms are referred to appropriate UMG designee for payment exceptions. Patients needing financial assistance are referred to appropriate programs. 5%
Minimum Education
High School diploma or equivalent
Minimum Experience
2 years- Billing, Bookkeeping, or Accounting experience
Work Shift
Day (United States of America)
Location
Independence Pointe
Facility
7001 Corporate
Department
70019212 PBO Patient Access - Upstate
Share your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.
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