Pre-Services Representative - Remote

Surgery Partners, Inc•Brentwood, TN

8d•Remote

About The Position

This role involves insurance verification and eligibility, including pre-authorization/pre-certifications. The representative will document this information in the billing system and electronic document system. They will also seek ASC admin approval or rescheduling for non-authorized or low-margin cases. A key part of the role is contacting and counseling patients and families regarding insurance coverage, patient responsibility, and payment issues prior to surgery. The representative ensures all insurance, demographic, and eligibility information is accurately and timely entered into the billing system, registers patients, and collects and revises patient insurance information. Additionally, they are responsible for collecting co-pays, deductibles, and other out-of-pocket amounts prior to or at the time of service.

Requirements

High school diploma or GED required.
Two years minimum front office experience in a medical environment; experience with insurance and scheduling.
Experience with Payor portal, authorization, Payor payment policy, and contract reimbursement.
ICD-10 and CPT code knowledge.
Strong customer service skills.
Strong initiative and ability to work in a team environment.

Nice To Haves

College degree a plus.
PSR

Responsibilities

Insurance verification and eligibility.
Insurance pre-authorization/pre-certifications verification and documentation in the billing system as well as electronic document system.
Seek ASC admin approval or rescheduling of any non-authorized or low margin cases.
Contact and council patients and families on insurance coverage, patient responsibility, and payment issues prior to surgery.
Ensure all insurance, demographic, and eligibility information is obtained from patients and entered in the billing system in an accurate and timely manner.
Register patients in the system.
Collect and revise all patient insurance information.
Collect co-pays, deductibles, and other out-of-pocket amounts prior to or at the time of service by patient request.