Call Center Representative

Jersey Community Hospital•Jerseyville, IL

3d•Onsite

About The Position

Verifies insurance benefits. Processes accounts to ensure that patients are preregistered & required insurance authorizations and/pre-certifications are obtained prior to the date of service. Communicates with patients and insurance companies regarding coverage, deposits, and other related matters. Discusses benefits with patients, responds to patient/third party inquiries, and makes referrals. Schedules patient’s procedures. Informs patients of pre-op instructions. Performs scheduling/referral duties according to established procedures. Prepares patient schedules/documentation for departments. Completes insurance verification/pre-certification according to payor requirements; identifies outpatient procedures that require pre-certification/second opinion; obtains required information from physician; pre-certifies inpatient admissions. Requests pre-payments and informs patients of discounts. Completes Medicare Questionnaire; ensures that medical necessity is established for Medicare/Medicaid patients. Others roles and responsibilities as assigned.

Requirements

Excellent communication and interpersonal skills required to discuss financial matters with patients and/or their representative, and to work with all levels of professionals at JCH and in other organizations.
Ability to comprehend large amounts of complex information, and explain complex insurance benefits to patients and/or their representatives.
Ability to respond to quickly changing priorities and patient needs.
Demonstrated computer skills and related experience preferred.
Motor coordination and finger dexterity required to operate computer equipment and other office machines.
Work is of light demand with routine lifting requirements up to 25 pounds.

Responsibilities

Verifies insurance benefits.
Processes accounts to ensure that patients are preregistered & required insurance authorizations and/pre-certifications are obtained prior to the date of service.
Communicates with patients and insurance companies regarding coverage, deposits, and other related matters.
Discusses benefits with patients, responds to patient/third party inquiries, and makes referrals.
Schedules patient’s procedures.
Informs patients of pre-op instructions.
Performs scheduling/referral duties according to established procedures.
Prepares patient schedules/documentation for departments.
Completes insurance verification/pre-certification according to payor requirements; identifies outpatient procedures that require pre-certification/second opinion; obtains required information from physician; pre-certifies inpatient admissions.
Requests pre-payments and informs patients of discounts.
Completes Medicare Questionnaire; ensures that medical necessity is established for Medicare/Medicaid patients.
Performs other roles and responsibilities as assigned.