Registration Precert Clerk - Patient Access - Lincoln - FT - Shift 1

Overview

Responsible for reviewing requests for services that require pre-certification and or referrals. Responsible for verifying authorization information obtained by outside referring physicians. Responsible for contacting scheduled patients and verifying all information on account is up to date and accurate.

Responsibilities

·         Pre-certify all patients for testing, and procedures as required by each patient’s insurance company by monitoring patient schedules in the billing system for each department.

·         Follow insurance company pre-certification requirements for approval, such as calling, faxing, emailing, logging into their system online, etc.

·         Assist accounts receivable, coding, registration, and insurance follow-up staff on an as-needed basis.

·         Answers telephone calls from employees regarding pre-cert requirement for various insurance companies.

·         Reviews pre-cert requirements for insurance companies on timely basis to maintain up-to-date knowledge of requirements.

·         Notifies appropriate staff of approval or denials.

·         Forwards denials to manager and appropriate staff for further review and decision making

·         Maintains strictest confidentiality.

·         Contacts all scheduled patients prior to their appointment to confirm all information on the account is accurate and up to date.

·         Works closely with Clear Health to establish and deploy patient liability estimates for their upcoming scheduled procedure.

·         Performs related work as required.

Qualifications

·         Knowledge of accounts receivable practices and medical patient accounting services procedures.

·         Knowledge of coding and clinic operating policies and procedures.

·         Knowledge of insurance agency reimbursement procedures and practices.

·         Knowledge of the organization’s policies and procedures.

·         Skill in using computer and calculator.

·         Ability to examine documents for accuracy and completeness.

·         Ability to prepare records in accordance with detailed instructions.

·         Ability to work effectively with co-workers and supervisors as a team member.

·         Ability to communicate clearly.

·         Upholds effective work habits including, but not limited to, regular attendance, teamwork, initiative, dependability and promptness.