Pre-Certification Associate

HIGHLAND DISTRICT HOSPITAL•Hillsboro, OH

3d•Onsite

About The Position

The Pre-Certification Associate completes pre-certification/preauthorization and pre-registration for inpatients and scheduled outpatients in a timely manner. The role includes insurance verification, collecting and confirming patient information, and communicating financial obligations. The associate works with physicians, physician office personnel, department managers, and other hospital personnel to support the pre-certification and pre-registration program. The position reports directly to the Patient Registration/Central Scheduling Manager. Employees are expected to treat patients, visitors, and coworkers with compassion, dignity, and respect; support teamwork and the hospital’s A-I-D-E-T customer service initiative; and comply with HDH corporate compliance and safety standards. The role normally works an eight-hour daytime shift, with willingness to work according to hospital needs.

Requirements

High school diploma or GED.
At least 3 years of registration experience.
Knowledge of insurance requirements.
Strong organizational skills.
Highly motivated and self-directed.
Ability to manage multiple tasks.
Verbal and written communication skills.
Problem-solving skills.
Presentation skills.
Ability to handle stressful situations and heavy workloads, and occasional irregular hours.
Requires vision in both eyes, use of two hands and two feet, and the ability to sit, walk, bend, stoop, and climb stairs or step stools/stepladders for extended periods without physical limitations that prevent these activities.
Ability to lift 10 pounds above shoulder level.
Close mental and visual attention to detail.
Successful completion of a medical examination after an offer of hire.
Must be free of unlawful substances and alcohol.
Ability to work cooperatively, flexibly, and resourcefully with physicians, physician office personnel, department managers, and other hospital personnel.
Willingness to work according to hospital needs.

Nice To Haves

At least 2 years of college in a healthcare-related field.
At least 5 years of patient registration experience, knowledge of insurance requirements, and billing experience.

Responsibilities

Complete pre-certification/preauthorization for inpatients, observation patients, scheduled surgical procedures, endoscopies, and scheduled outpatients.
Verify insurance coverage and requirements.
Pre-register patients with accurate and complete information.
Verify or identify patient demographic and guarantor information.
Inform patients of their financial obligations.
Obtain necessary information, including physician orders.
Refer patients to a Patient Financial Services Representative as needed.
Develop and maintain an insurance pre-certification/verification guide.
Assist with developing policies, procedures, forms, and processes.
Work with appropriate department representatives to develop and support the Pre-certification/Pre-registration program.
Treat patients, visitors, and coworkers with compassion, dignity, and respect, and promote teamwork and the A-I-D-E-T customer service initiative.
Adhere to HDH Corporate Compliance Program initiatives and standards and comply with HDH safety standards, policies, and procedures.