What are the responsibilities and job description for the Patient Services - Preregistration Specialist position at Orthopaedic Associates?
Orthopaedic Associates is a fast-paced, 11-physician orthopaedic practice with four practice locations in Evansville and Newburgh, IN and Henderson, KY. We are currently seeking a detail-oriented and knowledgeable Preregistration Specialist to join our team. This would be a full-time position and would be benefits eligible. We are closed on the six major holidays and new employees are eligible for holiday pay and insurance after completing their first 60 days of employment. We also offer a lucrative PTO plan and 401k with a matching component. This position would work from our business office but may at times need to work from one of our practice locations. Hours are generally Monday - Friday, 8am - 4:30pm. We also offer a modified schedule, working 9 hours four days a week and one 4 hour shift once per week.
The Preregistration Specialist will work closely with the Front Desk, Billing, and Patient Services departments to verify insurance coverage and ensure compliance with policies and regulations. This role is responsible for managing and processing all insurance related activities.
ESSENTIAL DUTIES AND RESPONSIBILITIES
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Ability to identify in and out of network health plans and networks according to Orthopaedic Associates’ contracts
- Verify insurance eligibility and benefits to ensure proper insurance coverage prior to any services
- Ensure transparency of benefits and patient financial responsibility (deductible, coinsurance) awareness
- Oversee pre-registration completed by front desk staff to ensure patient insurance eligibility for upcoming appointment
- Answer staff and patient insurance questions
- Contact insurance companies via phone and insurance web-based systems
- Update EMR with accurate insurance information
- Ability to comprehend EOB and explain definitions of out of pocket, deductible, co-insurance and other medical terminology
- Determine prior authorization requirements (office visit/injections/DME) and/or medical policy exclusions
- Collaborate with billing department/insurance card training and education
- Assist with payor mapping (new insurance being loaded into Epic)
- Maintain patient confidentiality, compliance with company policies and procedures. Stay updated on healthcare regulations and compliance requirements to ensure accurate and lawful billing practices
EDUCATION AND/OR EXPERIENCE
High School diploma or GED certificate required. Minimum 1-2 years of experience in a health insurance field
- Strong knowledge of payor networks and insurance eligibility preferred
- Excellent communication and customer services skills
- Ability to multitask and work in a fast-paced environment
