Denial Prevention Analyst I (DPA I)

Quorum Health Corporate•Springfield, IL

4d•Remote

About The Position

The Denial Prevention Analyst position is responsible for pre-registering scheduled patients. The role includes conducting pre-service patient interviews, ensuring a complete and accurate billing record for the scheduled service, as well as collecting estimated patient financial liabilities. These efforts will result in increased net revenue by reducing bad debt and potential write-offs due to a lack of patient collections or front-end related denials. Interactions will be conducted with providers, payers, patients, and hospital-based personnel. Duties are to be performed accurately and timely while providing exceptional customer service.

Requirements

Proficient in typing.
General knowledge of medical terminology.
Ability to communicate effectively and professionally in English, both verbally and in writing.
Critical thinking and problem-solving skills.
High school graduate or equivalent.

Nice To Haves

Bilingual a plus.
One year of previous scheduling experience in the medical field is preferred.

Responsibilities

Responsible for interviewing patients via phone through inbound/outbound efforts while completing the pre-registration process.
Responsible to comply with regulatory requirements during the pre-registration process. Including but not limited to completing the Medicare Secondary Payer Questionnaire.
Responsible to educate patients on their estimated out of packet financial responsibility.
Collects liabilities while within the guidelines set forth by the organization.
Responsible to escalate high dollar out of pocket accounts at risk for non-patient payment prior to services being rendered.
Resolves patient demographic and insurance discrepancies as identified through various system tools.
Responsible for thoroughly and accurately documenting the outcome of the patient interview while delivering excellent customer service.
Responsible to observe privacy, safety, and security procedures, using equipment and materials properly.
Possesses the ability to work within a remote call center environment free from distractions and background noise.
Recognizes and consistently exhibits exceptional customer service as a critical factor in all duties performed.