Pre-Registration Representative - Pre-Registration HSD - FT - Day

Status: Non-ExemptA Brief OverviewThis position plays a vital part in ensuring patients receive needed care and that insurance billing is accurate with benefit to both the patient and the organization. Duties include, but are not limited to scheduling, insurance verification for benefits and eligibility, completion of prior authorizations/pre-certifications, estimates of patient responsibility and preregistration of the patient for a positive customer experience.

Education QualificationsHigh School Diploma / GED RequiredAssociate's Degree PreferredExperience Qualifications2 years Physician office, hospital or payer setting with experience relating to patient registration, patient scheduling, exam or procedure scheduling, prior authorization completion or insurance verification. RequiredSkills and AbilitiesKnowledge of medical terminology (Required proficiency)Knowledge of MicroSoft Windows applications (Preferred proficiency)Excellent customer service skills (Preferred proficiency)Excellent interpersonal & communication skills with the ability to exhibit patience.

(Preferred proficiency)Ability to prioritize and handle multiple tasks (Preferred proficiency)

Schedules patients for hospital services based upon physician orders. This includes scheduling of complex cases, which require the coordination of multiple resources and determination of need for lab work pre-services. Cancels and reschedules appointments as needed.

Works with service departments to coordinate the scheduling of urgent same-day add-ons. Completes insurance verification which includes determining in or out of network status, verifying insurance eligibility and benefits with the payer, coordinating multiple insurance coverages, identifying insurance coverage when needed and all other activities relating to the review of insurance. Completes the preregistration of scheduled patients via phone by collecting patient demographics, insurance information, accident information, and verifying insurance coverage with payer, educating patient on when and where to arrive for service and any rules related to arrival.

Completes prior authorizations for identified services. Includes review of medical policies to ensure all criteria is met, the process of completing the prior authorization with the payer and the documentation of prior authorization numbers for inclusion on the claim. Completes precertification (or “Notice of Admission”) for inpatient and identified outpatient admissions with payers after patient arrival.

Includes entry of received information into the electronic record for downstream processes. Creates estimates for identified services within appropriate timeframes. This includes providing financial education to the patient on anticipated balances and the collection of anticipated balances.

Mentors, orients and provides at-the-elbow training for new staff. Prepares paper and electronic documents for scanning into Epic. Answers benefits and eligibility questions from patients, office staff, Case Management, Social Work or any other source.

Reviews incoming faxes and distributes to appropriate departments within the organization. When requested, reviews standard work and training materials for clarity and accuracy. Participates in process improvement activities.

Required for All JobsComplies with all policies, standards, mandatory training and requirements of Stormont Vail HealthPerforms other duties as assignedPatient Facing OptionsPosition is Not Patient FacingRemote Work GuidelinesWorkspace is a quiet and distraction-free allowing the ability to comply with all security and privacy standards. Stable access to electricity and a minimum of 25mb upload and internet speed. Dedicate full attention to the job duties and communication with others during working hours.

Adhere to break and attendance schedules agreed upon with supervisor. Abide by Stormont Vail’s Remote Worker Policy and will review and acknowledge the Remote Work Agreement annually. Remote Work CapabilityHybridScopeNo Supervisory ResponsibilityNo Budget Responsibility No Budget ResponsibilityPhysical DemandsCarrying: Rarely less than 1 hourEye/Hand/Foot Coordination: Frequently 3-5 HoursHearing: Continuously greater than 5 hoursReaching (Forward): Rarely less than 1 hourRepetitive Motions: Continuously greater than 5 hoursSitting: Continuously greater than 5 hoursStanding: Rarely less than 1 hourTalking: Continuously greater than 5 hoursStormont Vail is an equal opportunity employer and adheres to the philosophy and practice of providing equal opportunities for all employees and prospective employees, without regard to the following classifications: race, color, ethnicity, sex, sexual orientation, gender identity and expression, religion, national origin, citizenship, age, marital status, uniformed service, disability or genetic information.

This applies to all aspects of employment practices including hiring, firing, pay, benefits, promotions, lateral movements, job training, and any other terms or conditions of employment. Retaliation is prohibited against any person who files a claim of discrimination, participates in a discrimination investigation, or otherwise opposes an unlawful employment act based upon the above classifications.