Preservice Specialist I - (FT, Days)

Northwell Health•Danbury, CT

7d•Hybrid

About The Position

The Preservice Specialist I facilitates patient flow through the referral, scheduling, and financial clearance process. The role obtains demographic and financial information to support accurate patient identification and reimbursement, performs pre-registration and insurance eligibility verification, provides service estimates, and requests and secures payments. This is a full-time, Monday–Friday position with hours of 9:00 a.m. to 5:30 p.m. The role is hybrid-remote, with the first 90 days on-site in Danbury, Connecticut. It is part of Corporate Financial Clearance.

Requirements

High school diploma.
At least 2 years of job-related experience.
NAHAM certification within one year of hire.
Basic Microsoft Word and Microsoft Excel skills.
Customer service and organizational skills.

Nice To Haves

Associate's degree.
Six months of job-related experience (preferred with an associate's degree).

Responsibilities

May schedule patients for hospital or medical group services through incoming calls, online requests, or outbound calls.
May work in the central referral management system to identify and schedule specialist and primary care referrals to NHMP practices or external providers when appropriate, supporting in-system patient retention and continuity of care.
Provide customer service to physician offices and patients, and contribute to reducing abandoned calls, call length, and average speed to answer through best practices and workflow improvements.
Receive incoming faxed physician orders and verify them for compliance and accuracy.
Verify insurance eligibility and meet payer requirements; obtain benefit information such as deductible, copay, and coinsurance amounts; and use the patient estimation tool to calculate estimated patient liabilities.
Initiate authorization, pre-certification, notice-of-admission, and referral requests with insurance companies, and follow up with payers and providers to ensure authorizations are in place.
Take appropriate steps to resolve incomplete financial clearance so Nuvance Health receives prompt payment for services rendered.
Contact patients for pre-registration, verify demographic information, explain insurance benefits and estimated liabilities, and collect liabilities before the time of service using provided scripting.
Refer patients expressing financial hardship to Financial Counseling for a financial assessment.
Protect patient confidentiality and fulfill compliance responsibilities in accordance with department, organization, state, and federal guidelines.
Perform other duties as assigned.