What are the responsibilities and job description for the Elliot Health System - Pre-Services Specialist - Interventional Spine - Full Time position at Elliot Hospital?
About Us
The Elliot Pain Management and Interventional Spine Center at River's Edge is a multi-disciplinary group of professionals committed to the compassionate treatment of patients in pain. The Center specializes in the scientific assessment, diagnosis, and treatment of pain-related disorders. We believe that early diagnosis and minimally invasive interventional therapy substantially reduces the number of patients requiring surgery or proceeding toward disability.
Position Summary - Monday-Friday, 8am-5:00pm, 40 hours weekly
Pre-Services Specialists are dedicated to completing patient access workflows related to scheduled patient services for the inpatient, ambulatory, and physician practice settings. Pre-Services Specialists work directly with referring physician offices, payers, and patients to ensure full financial clearance prior to the provision of care.
What You’ll Do
The Elliot Pain Management and Interventional Spine Center at River's Edge is a multi-disciplinary group of professionals committed to the compassionate treatment of patients in pain. The Center specializes in the scientific assessment, diagnosis, and treatment of pain-related disorders. We believe that early diagnosis and minimally invasive interventional therapy substantially reduces the number of patients requiring surgery or proceeding toward disability.
Position Summary - Monday-Friday, 8am-5:00pm, 40 hours weekly
Pre-Services Specialists are dedicated to completing patient access workflows related to scheduled patient services for the inpatient, ambulatory, and physician practice settings. Pre-Services Specialists work directly with referring physician offices, payers, and patients to ensure full financial clearance prior to the provision of care.
What You’ll Do
- Follows established department policies to completely and accurately pre-register patients, verify insurance eligibility and benefits, validate precertification or referral status, and collect patient responsibility amounts for services provided throughout the EHS enterprise.
- Establishes contact with patients via inbound and outbound calls and accesses department Pre-Registration work queues to pre-register patients for future dates of service.
- Verifies insurance eligibility and benefits by utilizing integrated real-time eligibility tool, payer websites, and telephone calls to payers documents payer verification responses in designated fields within the registration pathway.
- Compares the primary care physician (PCP) information indicated by the insurance verification response to the location of the primary care office visit, if applicable; contacts the patient and provides guidance for resolution of PCP discrepancies or mismatches.
- Validates insurance referral status, if applicable, and communicates with PCP office to obtain referrals.
- Validates pre-certification status, if applicable, and communicates with ordering physicians’ offices to obtain pre-certification information; documents pre-certification status in designated field within the registration pathway.
- Provides notification of admission to payers within 24 hours of admission for inpatient stays.
- Initiates and completes the Medicare Secondary Payer Questionnaire (MSPQ) via a phone interview with the patient as necessary.
- Interprets insurance verification information to estimate patient financial responsibility amounts for scheduled services and inpatient stays.
- Communicates patient financial responsibility amounts and initiates the point of service (POS) collections process.
- Identifies patients requiring payment assistance options and facilitates communication between patients and EHS Financial Counselors.
- Works collaboratively with all departments/services of the Elliot Health System to ensure that all scheduled patients have undergone financial clearance prior to service.
- Receives and directs incoming calls for inpatient and outpatient services.
- Schedules and coordinates physician, patient, department and hospital resources to assure prompt patient services.
- Keeps informed of department needs and coordinates schedules to meet test and procedure requirements.
- Provides pre-test instructions to patients for selected tests/procedures to ensure that patients are appropriately prepared for testing.
- Promotes utilization of off-site facilities by educating patients as to services provided and location.
- Education: High school diploma or equivalent required.
- Experience: A minimum of one (1) year healthcare experience in Patient Access registration, pre-registration, insurance verification, or equivalent office/customer service experience preferred. Computer, telephone, fax machine. EPIC experience preferred.
- Knowledge: Knowledge of and compliance with confidentiality guidelines and EHS policies and procedures. Knowledge of insurance requirements and guidelines for Governmental and non-Governmental carriers. Knowledge of and compliance with regulatory guidelines, such as EMTALA, HIPAA, MSPQ, ABN, and Red Flag.
- Skills: Superior customer service skills and professional etiquette. Strong written and oral communication skills
- Health, dental, prescription, and vision coverage for full-time & part-time employees
- Short-term disability, long-term disability, and life insurance coverage
- Competitive pay
- Tuition Reimbursement
- 403(b) Retirement Savings Plan
- And more!
