Pre-certification specialist/Estimates | Full Time | Day shift

Position Description:

Complete scheduling, pre-certification, and registration of patients for all medical services in a timely and accurate manner ensuring accuracy of patient information and medical services ordered.

Minimal Qualifications:

1. Education:

a. High school graduate or equivalent preferred.

2. Experience:

a. One year registration in a health care environment preferred but may obtain on the job.

3. Personal skills/abilities:

a. Human relation skills are needed for personal interaction with other employees, patients,

physicians and the general public.

b. Temperamental ability to be pleasant, tactful, cooperative, responsible, compassionate and

courteous.

• Strong organizational skills required with ability to multi-task.
• Knowledge of insurance benefit and plan verification.
• Knowledge of third party payors.
• Experience in automated systems.
• Basic medical terminology.
• Ability to type 40 w.p.m.

Physical/Mental Demands:

The physical demands described here are representative of those that must be met by an employee

to successfully perform the essential functions of this job. Applicants who are disabled must be

able to perform the essential job functions either unaided or with assistance of a reasonable

accommodation to be determined on a case by case basis.

1. Verbal ability to communicate with patients and staff and understand instructions.

2. Manual dexterity is required in operate equipment required for the position.

3. Physical demands include periods of frequent sitting with heavy face to face

communication with the general public and performing repetitive motions effectively

under moderate stress and time restraints. Must be able to lift 20 pounds on a frequent

basis.

4. Sight and hearing ability to accurately observe pertinent details.

Equipment Used to Perform Job:

Basic office equipment

Occupational Exposure to Bloodborne Pathogens:

Class 3: Job in which employee has no occupational exposure

Disclaimer Statement:

The statements herein are intended to describe the general nature and level of work performed.

They are not intended to be construed as an exhaustive list of all responsibilities, duties, skills

and competencies required of personnel so classified.

The following are responsibilities of this position and the factors upon which evaluation is based:

1. Demonstrates support for the hospital mission/vision and commitment to our patients.

2. Continually seeks ways to improve the department efficiency and effectiveness.

3. Presents an accommodating and receptive manner to our employees and customers.

4. Presents a professional and positive image in appearance and communications.

5. Is dependable in meeting assigned work schedule and completing responsibilities.

6. Adheres to hospital, department and personnel policies.

7. Seeks job related education and attends required training.

8. Demonstrates competency in recognition and intervention in an emergency situation.

9. Cordially greets and registers patients upon arrival.

• Assists with requisitions for services from ancillary departments.
• Completes steps required for accurately scheduling and registering patients: confirming demographics and insurance data at each patient visit during the registration process, confirming physician signature and diagnosis are present on physician orders, checking medical necessity requirements, delivering privacy statements to patients, obtaining consent to treat and forwarding to appropriate department, updating pertinent patient/insurance/referral data as needed, scanning (front and back of all insurance cards, identification, physician orders) at time of visit, obtaining patients’ signature(s) as necessary, printing face sheets and labels, routing all forms to appropriate staff, estimating charges and collecting/posting monies due.
• Obtains clinical information for services requiring prior authorization or notification and submits to insurance company. Alerts appropriate staff and patients when pre-cert/authorization is not obtained before services are rendered.
• Accurately and promptly enters all discharges and/or transfers into system.
• Uses all necessary equipment appropriately and safely.
• Communicate with supervisor daily any problems and/or concerns with patient access process.
• Other duties as assigned.

As an employee in the above referenced position, I have read, understand and agree to abide by the job

description stated within.