Pre-Certification Associate

The Pre-certification Associate reports directly to the Patient Registration/Central Scheduling Manager and is responsible for the timely completion of pre-certification/preauthorization and pre-registration of inpatients and scheduled outpatients.

Position Accountabilities

· Pre-certification/pre-authorization of all inpatients, observation patients, scheduled surgical procedures, endoscopies and scheduled outpatients.

· Insurance verification.

· Pre-register patients with accurate and complete information.

· Verify and/or identify patient’s demographic and guarantor information.

· Inform patient of financial obligation.

· Obtain all necessary information (i.e., physician orders, etc.).

· Refer patients to Patient Financial Services Representative as needed.

· Develop and maintain an insurance pre-certification/verification guide.

· Assist in developing policies, procedures, forms and processes.

· Works with appropriate department representatives to assist in development of and success of the Pre-certification/Pre-registration program.

· Highland District Hospital is committed to serving our community by providing quality healthcare in an atmosphere of safety, compassion and excellence. It is the responsibility of all employees to interact with patients, visitors, and/or co-workers with compassion, dignity, and respect. Employees are to maintain positive behaviors, approaches and attitudes and commitment to interpersonal service. Each employee is to serve as a role model for the organization’s Customer Service initiative; A-I-D-E-T; Acknowledge – Introduce – Duration – Explanation – Thank-you; proactively promoting teamwork and a collaborative culture.

· Responsible for abiding by and adhering to all HDH Corporate Compliance Program initiatives and standards.

· Responsible for compliance with HDH safety standards, policies and procedures.

· The above statements are intended to describe the general nature and level of work being performed. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills of personnel so classified.

Education – Required: High School graduate or GED recipient

Education – Preferred: Minimum 2 years college in a healthcare related field.

Experience – Required: Minimum 3 years of registration experience, insurance requirement knowledge.

Experience – Preferred: Minimum 5 years patient registration experience, insurance requirement knowledge and billing experience.

Competencies Required:

• Strong organizational skills
• Highly motivated
• Self-directed
• Multi-tasked oriented
• Verbal and written communication skills
• Problem solving
• Presentation skills

Physical Demands: Physically and emotionally able to handle stressful situations, heavy workloads, and occasional irregular hours. The position requires vision in both eyes, the use of two hands, and use of two feet. Cannot have physical limitations that would prevent long periods of sitting, walking, bending, stooping, or climbing (steps, step stool, stepladder). Must be able to lift ten pounds in weight above shoulder level. Requires close mental and visual attention to detail.

The position requires the successful completion of a medical examination after offer of hire has been made. The position requires the employee to be free of all unlawful substances and alcohol.

Work Environment: Pre-certification Associate must demonstrate the ability to work with physicians, physician office personnel, department managers, and various other hospital personnel. Cooperation, flexibility, and resourcefulness are required in dealing with hospital personnel and medical staff. Conditions may be stressful at times. May be exposed to unpleasant patients and family members that require assistance.

Work Schedule: The Pre-certification Associate normally works an eight (8) hour shift during daytime hours. Must be willing to work according to hospital needs.