Under the supervision of Patient Access Manager, verifies, registers, scheduling of appointments and completes authorization for all third-party payors according to industry, federal and state, billing and collection regulations for all Infusion and other hospital related services. Maintains, abreast of all regulations affecting appropriate billing and collections of accounts, performs all clerical processing for completion and disposition of assigned accounts, handles patient, third party payor inquiries, makes necessary follow-up on those arrangements ensuring compliance with appropriate hospital and departmental collection policies and procedures assuring satisfactory disposition of all encounters.
III. Essential Job Functions:
o To work within the service standards; to support the vision of Ingalls Memorial Hospital and to provide the service of care which facilitate cost effective operations.
o Obtain/collect patient's pertinent socioeconomic information
o Under general supervision, verifies all insurance information provided by patients to ensure accurate and complete information according to third party payors and department protocols for billing purposes.
o Identifies and verifies insurance benefits prior to patient service, when applicable.
o Assures precertification requirements are met
o General knowledge of precert and authorization rules for third party payors
o Follow up with case managers, patient access and billing managers if special circumstances exist to ensure maximum reimbursement for Ingalls Memorial Hospital.
o Work closely with other hospital departments such as: Case Management, Medical Records, Admitting, Doctors' offices, Surgery, Patient Financial Services etc.
o The ability to deal effectively, empathetically, but professionally with patients, Insurance Companies and the general public
o Supports team by assisting members to learn, develop and grow in their ability to contribute to results.
o Assists patients, staff and other hospital departments on issues, problems or concerns as they relate to the Verification Department.
- CLINICAL EXCELLENCE
o Demonstrates a positive, supportive attitude when providing assistance to patients, family members
o Ensures that all verifications are performed according to organizational standards and in compliance with external and regulatory agencies.
o Monitors quality and productivity measurements which facilitate cost effective operations
- SERVICE EXCELLENCE
o Excellent Customer Service skills
o Demonstrates dedication to enhancing EXCELLENCE customer value and satisfaction
o Contributes to a positive work environment and hospital culture by exhibiting and nurturing service excellent concepts.
o Demonstrates attitude and behavior conductive to excellent patient care at all times.
o Must demonstrate dedication to enhance our EXCELLENT customer value and by extending their interactions to deliver quality service, which is responsible, comprehensive, and proactive
o Participates in enhancing the quality and efficient operations of the department
o Continue to strive for EXCELLENCE
Additional Job Functions:
o Follow up on daily correspondence
o Review of pre-registered encounters and appointments to insure proper pre-cert and authorizations
o Handling phone calls from insurance companies, doctor offices and internal departments
o Staying abreast of all insurance verification rules and regulations
o Maintain that all encounters needing verification is completed within 24 hours
o Requires the ability to handle a variety of task with speed, and attention to detail and accuracy
o Perform other job duties as assigned
V. Position Specifications:
- High school graduate or equivalent is required.
- Requires two to three years of demonstrated experience in hospital patient access, registration, or patient accounts
- With extensive knowledge in third party, payor/regulatory agency requirements.
- Working knowledge of computerized admission and accounts receivable systems
- Experience in basic computer software programs (Microsoft Word, Excel, and Outlook)
- Demonstrated ability to develop others in areas of continuous process improvement, customer
- service delivery and self-directed teamwork
- Excellent customer service skills
- Typing competency essential, 40-45wpm, and ten key calculator tests
- Requires the ability to handle a variety of tasks with speed and attention to detail and accuracy.
- Some Medical Terminology
- Good written and verbal communication skills
- Good Written and Verbal communication skills
- Ability to follow and complete detailed directions
- Must be detail oriented
- Requires good analytical and problem-solving ability
- Previous experience in a health care environment, preferably Central Scheduling, Call Center, Physician's office
- and/or other related health care experience is desired
- Job Type/FTE: Full Time (1.00)
- Shift: Days
- Unit/Department: Insurance Verification
- CBA Code: Non - Union
Must comply with Ingalls Memorial Hospital's COVID-19 Vaccination requirement as a condition of employment. If you have already received the vaccination, you must provide proof as part of the pre-employment process. This is in addition to your compliance with the Flu Vaccination requirement as well. Medical and religious exemptions will be considered consistent with applicable law. Lastly, a pre-employment physical, drug screening, and background check are also required for all employees prior to hire.
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