Pre Services Representative I - Hybrid - FT - Days - MSS

Memorial Healthcare

1d•Hybrid

About The Position

The Pre Services Representative I determines and verifies insurance coverage and coordinates insurance benefits from all sources. The role requests or verifies authorizations for ordered services; schedules or reschedules physician orders for outpatient treatments and diagnostic services; discusses financial responsibilities with patients or guarantors; collects upfront payments or reviews financial assistance options; and handles related inbound and outbound calls. This position requires excellent communication and critical-thinking skills, decisive judgment, and the ability to work with minimal supervision in a stressful environment. No prior work experience is required. Experience with hospital authorizations and knowledge of health insurance are preferred.

Requirements

High school diploma or equivalent.
Excellent communication skills.
Critical-thinking skills.
Decisive judgment.
Ability to work with minimal supervision.
Ability to work in a stressful environment and take appropriate action.

Nice To Haves

Experience with hospital authorizations.
Knowledge of health insurance.

Responsibilities

Communicate with patients and practitioners about orders, insurance, and authorization issues.
Notify patients of their financial responsibility for services and educate guarantors about out-of-pocket costs.
Collect pre-service payments in accordance with available financial options and departmental payment procedures.
Document call details and note any collections needed at registration.
Handle inbound and outbound calls related to scheduling, authorizations, benefits, and patient responsibilities.
Document call details and disposition in the appropriate record.
Input or review patient insurance benefits and rerun estimates as needed to correct expected out-of-pocket liability.
Update patient insurance information in the patient record to support accurate billing and net revenue estimates.
Confirm insurance coverage, determine whether pre-authorization is necessary, obtain authorization, and document authorization information in the patient account.
Review orders for an appropriate authorizing signature and accuracy of scheduled services.