Job Description :

PURPOSE OF JOB : Schedule and pre-register outpatients in a manner that will result in positive patient relations and prompt reimbursement for the facility's services.

ESSENTIAL FUNCTIONS :

1. Schedule patient appointments.

2. Complete an accurate pre-registration.

3. Verify patient's insurance eligibility and benefits.

4. Secure and / or verify authorization for services in accordance with payer guidelines and requirements.

5. Screen patient's financial responsibility for scheduled services. When appropriate, calculate estimate of patient's costs and communicate to patient during the scheduling call.

Provide multiple payment options and expected payment.

JOB CRITERIA AND PERFORMANCE STANDARDS :

Schedule

Initiate patient appointments in Community Wide Scheduling following established scheduler instructions for accurate / timely services.

Positively identify correct medical record and correct visit account, if previously established.

Read all patient instructions for appointment scheduled.

Pre-Registration

Positively identify the correct patient medical record and correct visit account, if previously established.

Review and prioritize all notifications for scheduled services including facsimiles, work lists and Meditech notifications received.

Enter / Verify complete demographic information. Resolve account errors in individual work queue's; maintain RQA quality score of 95% or greater.

Complete Medicare Secondary Payer questions as required.

Verify patient's insurance eligibility and benefits

Determine correct insurance plan identification, verify with patient when possible.

Verify eligibility and benefits using available online resources and according to department protocols.

Document accounts with payer data.

Secure / Verify authorization for services :

Verify and / or secure the specific related authorization requirements necessary to prevent later denial of charges by the carrier.

Monitor patient accounts until authorization requirements are completed.

Screen patient's financial responsibility

Collect patient financial responsibility if possible during the scheduling call, or offer patient payment options, including making the payment on the date of service.

Identify need for financial assistance and direct patients to appropriate resource.

Job Qualifications : QUALIFICATIONS :

QUALIFICATIONS :

Education : High School or equivalent is required.

Experience : Hospital / Insurance experience preferred.

Other Skills :

Excellent Customer Service Skills

Negotiation and Problem Solving Skill

Ability to prioritize and multi task

Excellent Communication Skills

Ability to work productively as a team

Mathematical skills

Last updated : 2024-05-13