Pre Service Specialist 1 - (FT, Days)

Northwell Health•Danbury, CT

6d•Hybrid

About The Position

The Pre Service Specialist facilitates patient flow through referral, scheduling, and financial clearance processes. The role obtains demographic and financial information for accurate patient identification and reimbursement, completes pre-registration and insurance eligibility verification, provides estimates for services, and requests and secures payments. This is a full-time, hybrid-remote position with a Monday–Friday schedule from 9:30 a.m. to 6:00 p.m. The first 90 days are onsite in Danbury, Connecticut. Depending on assignment, the specialist schedules hospital or medical group services, manages referrals, verifies insurance benefits, secures authorizations, and contacts patients to complete pre-registration and collect estimated liabilities. The role also protects patient confidentiality and fulfills applicable compliance responsibilities.

Requirements

High school diploma.
Minimum of 2 years of job-related experience.
NAHAM certification within one year of hire.
Basic Microsoft Word and Microsoft Excel skills.
Customer service and organizational skills.
Understanding of coding, procedural protocols, and the charge description master.

Nice To Haves

Associate's degree.
Six months of job-related experience.

Responsibilities

Schedule patients for hospital or medical group services through incoming phone calls, online requests, or outbound calls.
Work within the central referral management system to identify and schedule specialist and primary care referrals to NHMP practices or external providers when appropriate, supporting in-system patient retention and continuity of care.
Provide customer service to physician offices and patients, and contribute to reducing abandoned calls, call length, and average speed to answer through best practices and workflow improvements.
Receive incoming faxed physician orders and verify them for compliance and accuracy.
Verify insurance eligibility and meet payer requirements; obtain benefit information such as deductible, copay, and coinsurance amounts; and use the patient estimation tool to calculate patient liabilities.
Initiate and follow up on requests for authorizations, pre-certifications, notices of admission, and referrals with insurance companies and providers.
Take appropriate steps to resolve incomplete financial clearance so Health Quest Systems Inc receives prompt payment for services rendered.
Contact patients to complete pre-registration, verify demographic information, explain insurance benefits and estimated liabilities, and collect payments before service using provided scripts.
Refer patients who express financial hardship to Financial Counseling for a financial assessment.
Safeguard patient confidentiality and fulfill compliance responsibilities in accordance with department, organization, state, and federal guidelines.
Perform other duties as assigned.