Pre Services Representative - Concord Hospital Laconia | Full Time | Days

Concord Hospital • Laconia, NH

20h • Onsite

About The Position

The Pre Services Representative is engaged in one or more of the revenue cycle roles including: pre-service scheduling and patient access, pre-registration, insurance verification, financial clearance and denial management.

Requirements

• Prior knowledge and expertise in insurance policies and coverage and medical necessity and prior authorization requirements.
• Minimum of three years experience in a healthcare or related environment.
• Working knowledge of medical terminology, Microsoft Office applications and the ability to navigate in a Windows based environment.
• Proven exceptional communication skills, critical thinking and problem solving skills, and interpersonal skills.
• Ability to work well in a team environment and possess ability to work independently as well.

Responsibilities

• Performs insurance authorization for elective outpatient radiology imaging and cardiovascular testing.
• Schedules, reschedules and cancels appointments and enters data into Schapptbook according to program logic and Scheduling Guidelines.
• Handles phone calls in a professional and efficient manner adhering to department call standards for Pre Services.
• Using appropriate schedules and work lists verifies insurance benefits and approvals for outpatient imaging, elective procedures and surgical cases and urgent/emergent admissions.
• Notify Payers of patient admissions/placed in observation as required by payers.
• Manages Faxes received in the Work Queue Monitor Program.
• Communicates and responds to patients, provider(s), payers and other associates/business partners and joint ventures using available tools (Message Center in PowerChart, email/secure email or phones) to ensure accurate scheduling of appointments and billing of encounters.
• Researches and responds to requests for cost of care.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED