Pre-Services Representative - Roper Hospital

Roper St. Francis Healthcare•Charleston, SC

4d•Onsite

About The Position

Provides administrative support for the day to day operations of the Rehabilitation Services department and will be a resource to the therapist for the electronic documentation system. Performs duties to include but not limited to filing, data entry, word processing, ordering supplies, answering phones, and scheduling patient treatment sessions. Providing excellent customer service to patients upon arrival. Gathers appropriate information from patients or responsible parties in order to completely register and verify insurance information to obtains pre-cert and authorizations for appropriate visits.

Requirements

High School degree or equivalent education (required)
Strong verbal communication skills including good voice quality, diction and articulation are required.
Must be able to communicate effectively with people of variable cultural and educational backgrounds.
Strong math skills required.
Must maintain strict confidentiality of patient demographics, concerns and financial information, as well as other sensitive information.
Customer Service skills and experience including an ability to work well with the public and an ability to adopt a customer perspective.
Ability to diplomatically and respectfully deal with customers (both in person and via telephone).
Must be detail oriented and possess good organizational skills
Must be able to handle multiple priorities and deadlines
Must demonstrate the ability work with little to no supervision and exercise independent judgment.

Nice To Haves

Minimum of 1 year’s experience in the Customer Service Field or Call Center in a patient financial health care setting (preferred)
Strong understanding of insurance benefits is recommended.
Medical terminology preferred.
Technical skills, including proficiency with computers, PC and Windows, multi-line phone systems and headsets experience is preferred.
The ability to handle multiple support systems is required.

Responsibilities

Registration/Preparing Charts.
Verify evaluation details and insurance information inputted by central scheduling.
Navigate in eCW and Cerner Powerchart to locate and print referral to place in chart.
Assuring entry into STAR registration system provides complete, accurate information regarding referral information.
Prepare patient chart for treatment and make packets of all patient paperwork that must be filled out upon arrival.
When patient arrives make copy of photo ID and insurance card; explain paperwork patient needs to fill out and review insurance benefits with patient.
Scheduling of patients/answering telephones and handling any issues/messages in timely manner.
When patient arrives, verify there has not been any changes to their insurance and check them in the computer system.
Verify account information to ensure their account is still open and current, follow up on insurance benefits with visit limit and expiration date.
Scheduling patients in scheduling appointment book at least 2 weeks in advance.
Submitting insurance authorizations.
When a patient needs authorization, make sure the therapist provides proper documentation including plan of care, treatment note, standardized assessment tools, referral, and any insurance authorization forms.
Depending on insurance the authorization can be started online, on the phone, or by faxing clinical information.
Processing times very and authorization status should be checked daily.
When an authorization is approved: fax approval letter to medical records; enter authorization information in Account Notes in STAR and print to notify patient and treating therapist.
Once authorization has been approved and filed in the chart, call patient to schedule follow up appointment.
Keeping track of patient accounts.
Utilize the Authorization tracker to keep an eye on existing authorizations and actively count # of visits left for each patient/watch out for DOS end date.
Coordinate with the therapist when the patient is reaching the end of authorization to gage whether more authorization is required or if the patient will be discharged
Effective communication with Doctor’s offices and other disciplines/departments regarding patient care.
When a new referral is needed, contact the referring physician’s office via phone or telephone encounter.
If a referral is needed for a past date, ask the therapist to fill out an Additional Rehab Order Form and sign it for the requested date.
Fax to referring physician.
Occasional Progress Notes or Plan of Cares that fall outside of those that are automatically sent should be faxed to the referring physician for review or signature.
Communicate to doctor’s offices to notify them when patients are discharging from therapy services, it patient did not show up for initial evaluation, or if there are any additional questions/requests regarding patient care.
Retrieve and review information from EMR reports regarding account conflicts, unsigned notes and lack of documentation to support medical necessity.
Review HPF queues for issues and work to resolve in timely manner to ensure all patient account information, charges, billing and follow up are accurate and complete

Benefits

Competitive pay, incentives, referral bonuses and 403(b) with employer contributions (when eligible)
Medical, dental, vision, prescription coverage, HAS/FSA options, life insurance, mental health resources and discounts
Paid time off, parental and FMLA leave, and short- and long-term disability
Tuition assistance, professional development and continuing education support

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