Pre-Reg Pre-Cert Specialist

The University of Kansas Health System

4d • Remote

About The Position

The Pre-Reg/Pre-Cert Specialist identifies patients eligible for pre-registration, including new and returning patients. The specialist obtains identification to verify demographic and insurance information and enters the information into registration systems. The position also handles pre-service collections and documentation when applicable, and verifies, notifies, and obtains authorization for admissions and outpatient visits. For sponsored admissions, the specialist contacts patients’ employers and/or insurance companies to verify coverage and benefits, determine benefit levels and patient liability, and obtain billing addresses.

Requirements

• High school graduate or GED.

Nice To Haves

• One or more years of experience with Epic.
• One or more years of prior experience in pre-registration or prior authorization.

Responsibilities

• Work daily reports and worklists to identify patients who have not been contacted before service and complete pre-registration and pre-certification for hospital services.
• Conduct telephone interviews with patients as needed to collect demographic and third-party payer information for billing.
• Enter patient information into registration systems and ensure the Medicare Secondary Payer Questionnaire (MSPQ) is completed when appropriate.
• Verify dependent eligibility, certificate and group numbers, copayments, deductibles, statement mailing addresses, and other coverage details with third-party payers; comply with applicable Medicare, Medicaid, and other insurance rules.
• Coordinate with clinics, hospital ancillary departments, and patient financial advisors regarding potential insurance-coverage complications.
• Secure accounts under departmental policy by contacting patients, responsible payers, and employers; referring uninsured and underinsured accounts to Financial Advisors; and taking other necessary actions.
• Immediately notify provider offices of service restrictions, including inability to obtain pre-certification or participation in an agency lock-in program.
• Perform the professional, clinical, and/or technical competencies required by the assigned unit or department.
• Perform other duties as assigned.

What This Job Offers

• Job Type: Part-time
• Education Level: High school or GED