Job Details

Description

Coordinates activities within the Business Office in the areas of Admissions, Scheduling, Insurance Verifications/Pre-Certifications, and Medical Records. This role will be highly focused on insurance verification and pre-certifications. Typical schedule will be weekdays 9am-5pm.

Qualifications

High School Diploma, Associates Degree preferred
Experience in a surgical facility preferred
Ability to interface with insurance carriers, with a strong understanding of patient benefits
Strong written and verbal communication skills required, able to speak effectively to internal and external customers required
Strong working knowledge of Microsoft Outlook, Word and Excel

Essential Functions

Insurance Verifications/Pre-Certifications

Act as liaison between patient, physician office, and insurance company to assist patients with regards to financial responsibility
Notify all scheduled patients of their financial responsibility prior to their date of service
Verify patient insurance eligibility and benefits using technology tools, the telephone and the internet to ensure compliance with the facilities policies and procedures
Coordinate with insurance providers and the physician office to obtain pre-authorizations. Document the authorizations in the system patient accounts
Obtain information for medical necessity determination and coordinate with the physician office if additional information is needed
Communicate with patients to obtain any missing information necessary to achieve financial clearance.
Perform Benefit verifications on all new patients
Obtains and verifies patient demographic and financial information

Admissions

Admits patients to the Facility following the established policies and procedures
Collect patient out of pocket responsibilities at the time of check in, acknowledge collection on the SC1000 Scheduling Report, and sign off on daily receipts
Assembles patient medical record forms and prepares patient identification
Provides pertinent information to the patient’s family in the waiting area according to policies and procedures
Answers telephone and intercom courteously and in a quiet, pleasant voice
Maintains and protects each patient’s right to confidentiality
Identifies emergencies and initiates appropriate response

Scheduling

Considers priorities and special needs when scheduling surgical procedures
Maintains schedule according to policies on nursing and anesthesia staff availability, patient needs and physician’s block time
Coordinates schedule in a manner to minimize conflict, and adjusts schedule as appropriate

Medical Record

Check each medical record for completeness, marking and attaching a deficiency slip as needed
Performs release of information functions as necessary, per facility policy, state and federal regulations, and HIPAA guidelines
Maintain a log of record requests received, processed, and mailed out
Assist Medical Staff with completion of medical records

General Business Office

Cross train as required to assist with overflow responsibilities
Exhibit flexibility in work schedules and assigned tasks
Maintains minimal error rate
Participates in group meetings and/or various committees
Makes suggestions on workflow improvements
Notifies Business Office Manager of any issues
Maintains a positive attitude toward their position and responsibilities
Other duties and project work as requested

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job the employee is frequently required to sit, converse, and listen; use hands to touch, handle, or feel objects, tools or controls; and to reach with hands and arms. Specific vision abilities required by this job include close vision and the ability to adjust focus.

The employee must be able to lift and/or carry over 20 pounds on a regular basis and be able to push/pull over 25 pounds on a regular basis.

The employee must be able to stand and/or walk at least five hours per day.

Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Salary Range

Benefits Information: www.nuehealthbenefits.com

NueHealth LLC

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