Southern NH Health - Pre-Services Specialist - Full Time

SolutionHealth • Nashua, NH

4d

About The Position

To provide superior service excellence and promote the Southern New Hampshire Health Medical Center experience to all who access Southern New Hampshire Health. Pre-Services Specialists are members of the Patient Access team dedicated to completing patient access workflows related to scheduled patient services for the inpatient, ambulatory, and physician practice settings. Pre-Services Specialists work directly with referring physician offices, payers, and patients to ensure full financial clearance prior to the provision of care. Employees are required to work consistently to demonstrate the mission, vision, beliefs, core values, and standards of behavior of the organization.

Requirements

• High school diploma or equivalent required; associate degree preferred.
• Minimum of one (1) year in healthcare patient access, registration, pre-registration, or insurance verification OR equivalent office/customer service experience preferred.
• Superior customer service and professional etiquette.
• Strong written and oral communication skills.
• Attention to detail and ability to multi-task in complex situations.
• Problem-solving independently or as part of a team.
• Insurance requirements for governmental and non-governmental carriers.
• Compliance with confidentiality guidelines and regulatory standards (EMTALA, HIPAA, MSPQ, ABN, Red Flag).
• Computer proficiency; EPIC experience preferred.

Responsibilities

• Pre-register patients accurately, verify insurance eligibility and benefits, validate pre-certification or referral status, and collect patient responsibility amounts for services provided throughout the enterprise.
• Establish contact with patients via inbound and outbound calls and manage pre-registration work queues for future dates of service.
• Verify insurance eligibility and benefits using real-time tools, payer websites, and phone calls; document responses in designated fields.
• Compare PCP information from insurance verification to office visit location; resolve discrepancies with patients.
• Validate referral and pre-certification status, communicating with PCP and ordering physician offices as needed.
• Notify payers of inpatient admissions within 24 hours.
• Complete Medicare Secondary Payer Questionnaire (MSPQ) via phone interview when necessary.
• Estimate patient financial responsibility amounts and communicate these to patients; initiate point-of-service collections.
• Identify patients needing payment assistance and connect them with Financial Counselors.
• Collaborate with departments to ensure financial clearance prior to service.
• Receive and direct incoming calls for inpatient and outpatient services.
• Schedule and coordinate physician, patient, department, and hospital resources for timely services.
• Provide pre-test instructions to patients for selected tests/procedures.
• Promote utilization of off-site facilities by educating patients about services and locations.

Benefits

• Health, dental, prescription, and vision coverage for full-time & part-time employees
• Short-term, long-term disability, life & pet insurance
• Tuition reimbursement
• Nursing Student Loan Paydown Program
• 403(b) Retirement savings plans with company matching
• Continuous earned time accrual & more!

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees