PreService Scheduling Specialist Part-Time Days - HYBRID

Trinity Health•Boise, ID

1d•Hybrid

About The Position

Saint Alphonsus Health System is hiring a PreService Specialist to support the Regional Scheduling Team. This position is responsible for scheduling patients for services within Saint Alphonsus Health System, performing insurance verification and prior authorizations, and notifying patients of their appointments prior to services being rendered. Training will be on-site for at least 3 months; it will be the decision of the Manager when new colleagues are ready to being working a hybrid schedule.

Requirements

High school diploma or equivalent required.
Data entry skills (50-60 keystrokes per minute).

Nice To Haves

Associate degree or an equivalent combination of education and experience preferred but not required.
Past work experience of at least 2 years within healthcare and/or payer environment performing patient access and/or customer service activities is highly desired but not required.

Responsibilities

Responsible for pre-registering the patient for upcoming visit(s) by interviewing the patient, family member and/or guarantor.
Validates, obtains and enters demographic, clinical, financial, and insurance information into the patient accounting system.
Utilizes multiple modes of communication (phone, fax, patient portal/e-mail, mail, etc.) and in a professional, accurate, efficient and courteous manner to obtain information and ensure good patient relations and a smooth billing process.
During pre-registration calls, the position will provide information regarding directions, parking, transportation service, overnight accommodations, etc. Pre-Registration may be initiated by Scheduling staff with follow-up by the Pre-Service Specialist to ensure data integrity and completeness.
Performs insurance eligibility/benefit verification, utilizing a variety of mechanisms (primarily EDI transactions and payer web access, and in some cases by calling payers directly) and documenting information within the patient accounting system. Outcomes of the insurance eligibility/benefit verification activity will determine next steps (designation as a Self-Pay account, referral to financial counseling, etc.).
Determines need for appropriate service authorizations (pre-certifications, third-party authorizations, referrals) and will contact the physician and Case Management/Utilization Review personnel, as necessary.
Informs patient/guarantor of their liabilities and collects appropriate patient liabilities, including co-payments, co-insurances, deductibles, deposits and outstanding balances at the point of pre-registration. Calculates patient liabilities and provides financial education, referring the patient to financial counseling, as required. Documents payments/actions in the patient accounting system and provides the patient with a payment receipt in the collection of funds.
Validates medical necessity (LCD/NCD review) of Medicare and Non-Medicare cases to ensure clinical and financial clearance. Contacts scheduling and/or ancillary department staff for clarification, if cases require clarification of diagnosis and/or test(s)/procedure(s).