Preservice Specialist I

Nuvance Health • Poughkeepsie, NY

6d

About The Position

At Nuvance Health, we cultivate an inclusive culture where everyone feels welcomed, respected and supported, with a team of 15,000+ strong hearts and open minds. This Preservice Specialist I role facilitates patient flow through the referral, scheduling, and financial clearance process. The specialist is responsible for obtaining demographic and financial information to ensure accurate patient identification and to secure reimbursement. Key functions include performing pre-registration, insurance eligibility verification, providing estimates for services, and requesting and securing payments.

Requirements

• HS Diploma Required
• Minimum of 2-year job-related experience
• National Association of Healthcare Access Management (NAHAM) certification within one year of hire
• Basic MS Word & MS Excel
• Customer service and organizational skills

Nice To Haves

• Associates Degree Preferred with 6 months job-related experience

Responsibilities

• May be assigned to schedule patients for hospital or medical group services by incoming phone calls, online requests, or outbound to patients.
• May be assigned to work within the central referral management system to identify and schedule specialist and primary care referrals to NHMP practices as well as external providers when appropriate, with the goal of promoting in-system retention of patients and continuity of care.
• Provides excellent customer service both to physician offices and patients. Contributes to reduction of abandoned call rate, length of calls, and average speed answered through use of best practices and workflow improvements as defined by management. Receives incoming faxed physician orders. Verifies orders for compliance and accuracy.
• Performs insurance eligibility verification and executes payer requirements as needed. Obtains accurate insurance benefit information from payers, such as deductible, copay, and coinsurance amounts. Utilizes patient estimation tool to calculate estimate of patient liabilities. Requires an understanding of coding, procedural protocols and the charge description master.
• Initiates requests for authorizations, pre-certifications, notices of admission, and referrals from insurance companies. Follows up with payers and providers to ensure that authorizations are in place. Takes appropriate steps to remediate situations in which financial clearance is not completed to ensure that Nuvance Health receives prompt payment for services rendered.
• Contacts patients to perform pre-registration, including demographic verification, conveyance of insurance benefits, and estimates of liabilities. Collects on such liabilities prior to time of service utilizing provided scripting. Refers patients who express financial hardship to Financial Counseling for a financial assessment.
• Safeguards patient confidentiality by adhering to all department, organization, state, and federal compliance guidelines. Fulfills all compliance responsibilities related to the position.
• Performs other duties as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 1,001-5,000 employees