Clinic Pre-Encounter Rep/Prior Authorization: Therapy Representative

Clinic Pre-Encounter Representative/Prior Authorization: Therapy Representative

POSITION DESCRIPTION:

The Clinic Pre-encounter Representative & Patient Access Specialist handles managing the complete patient access process, including scheduling, pre-registration, registration, insurance verification, and prior authorization. This position ensures smooth patient experience, compliance with payer guidelines, and accurate documentation to support prompt care and revenue cycle operations.

Supervisory Responsibilities:

• None

Duties/Responsibilities:

• Scheduling: outpatient/inpatient/Pediatric, potentially of multiple locations
• Guest Services
• Pre-registration
• Registration
• Insurance verification
• Pre-encounter collections
• Prior authorization
• As a condition of employment, completes all assigned training and skills competency.
• Compliance and Documentation: Maintain HIPPA Compliance and adhere to payer guidelines. Document all registration, authorization, and financial activities accurately in the system.
• Perform other duties as assigned to support patient access and revenue cycle operations.
• Rehab Aide Duties: cleaning, sanitizing, and prepping treatment rooms prior to patient care.

Nothing in this job description restricts MH ability to assign, reassign or eliminate duties and responsibilities of this job at any time. MH does not restrict the tasks that may be assigned. Critical features of this job have been described; those features may be changed at any time due to reasonable accommodation or other reasons deemed appropriate by MH.

Physical Requirements:

• Physically demanding, high-stress environment
• Sitting for extensive periods of time

• Ability to lift, move, push, or pull a minimum of fifteen pounds.

Required Skills/Abilities:

•  Must be a supportive team member, contribute to and be an example of teamwork.
• Ability to deal tactfully with personnel, residents, family members, visitors, government agencies/personnel, and the public.
• Excellent customer service skills.
• Able to communicate effectively in English, both verbally and in writing. Other languages are preferred.
• Basic computer skills, including ability to navigate electronic medical record systems.
• Subject to frequent interruptions.
• Knowledge of medical terminology
• Meticulous
• May work beyond normal working hours and on weekends holidays when necessary.
• Must be able to pass a background check and drug screening.

Education/Experience:

• High school diploma or equivalent.
• One to three (1-3) years’ experience in healthcare scheduling, authorization, customer service, or financial counseling.
• Knowledge of medical terminology
• Basic computer knowledge, data entry, and/or word processing.

Licenses/Certifications:

BLS certification

NON-DESCRIMINATION STATEMENT

It is the policy of McKenzie Health not to discriminate against any applicant for employment, or any employee because of age, color, sex, disability, national origin, race, religion, or veteran status.