Preservice Specialist I - (FT, Days)

Nuvance Health•Danbury, CT

43d•$18 - $26•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 ensure accurate patient identification and secure reimbursement, performs pre-registration and insurance eligibility verification, provides estimates for services, and requests and secures payments. Depending on assignment, the specialist schedules patients for hospital or medical group services or works in the central referral management system to schedule specialist and primary care referrals. The role supports patient retention and continuity of care, serves patients and physician offices, verifies orders and insurance benefits, coordinates authorizations and other payer requirements, and collects patient liabilities before services. The position is full-time, Monday through Friday, 9:00 a.m. to 5:30 p.m. It is hybrid-remote, with the first 90 days on-site in Danbury, Connecticut.

Requirements

High school diploma.
Minimum of 2 years of job-related experience.
National Association of Healthcare Access Management (NAHAM) certification within one year of hire.
Basic Microsoft Word and Microsoft Excel skills.
Customer service and organizational skills.
Understanding of coding, procedural protocols, and the charge description master.

Nice To Haves

Associate's degree.
Six months of job-related experience.

Responsibilities

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