Pre-Service Rep

Ochsner Clinic Foundation•Meridian, MS

About The Position

This job is responsible for assisting patients by communicating with insurance payors via various methods (i.e. telephone, fax, internet) to determine eligible benefits and acquiring Pre-Certification(s) when deemed necessary by the insurance payor. Additionally responsible for communicating the liability to the patient after the Pre-Certification has been obtained and ensuring the Pre-Service process has been completed in advance of the patient’s arrival for scheduled service(s). To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential duties. This job description is a summary of the primary duties and responsibilities of the job and position. It is not intended to be a comprehensive or all-inclusive listing of duties and responsibilities. Contents are subject to change at the company's discretion.

Requirements

Education Required – High School diploma or equivalent
Work Experience Required – 1 year related experience inf related hospital, clinic, medical office, business services/revenue cycle, front line registration, financial counseling, banking and/or customer service related job
Must have computer skills and dexterity required for data entry and retrieval of patient information.
Effective verbal and written communication skills and the ability to present information clearly and professionally to varying levels of individuals throughout the patient care process.
Must be proficient with Windows-style applications, keyboard, and various software packages specific to role.
Strong interpersonal skills.
Ability to multi-task.
Ability to perform effectively in a fast paced ever changing environment.
Ability to remain calm and professional in high pressure/stressful situations regarding patient financial and medical conversations.
Reliable transportation to travel to other facilities to fill in as needed.

Nice To Haves

Preferred – Associates Degree or Bachelor Degree
Preferred – Experience with of EPIC

Responsibilities

Prepares, validates and completes all steps necessary to clear new cases for pre-scheduled services. This includes, but is not limited, to validating and gathering insurance and demographic information.
Interacts with insurance companies via, website, phone, or fax to verify benefits, obtain authorizations, identify insurance guidelines, and facilitate communication.
Gathers information to verify benefits and benefits eligibility by s utilizing the EPIC system.
Completes and obtains all necessary authorizations for the service(s) to be performed.
Works with the clinical providers , on- site case management team, as well as LPN/RN or Nurse Auditor in the Pre-Service department.
Performs Pre-Service collection estimation functions and communicates patient liability.
Provides point –of – service information and logistics to ensure an exceptional patient experience.
Other related duties as required.
Remains knowledgeable on current federal, state and local laws, accreditation standards or regulatory agency requirements that apply to the assigned area of responsibility and ensures compliance with all such laws, regulations and standards.
This employer maintains and complies with its Compliance & Privacy Program and Standards of Conduct, including the immediate reporting of any known or suspected unethical or questionable behaviors or conduct; patient/employee safety, patient privacy, and/or other compliance-related concerns.