Precertification Specialist - Biloxi Central Scheduling - Days - FT- Biloxi Location

The Precertification Specialist I is responsible for verifying patient demographics and insurance benefits, assuring authorizations for service are in place, and informing patient of estimated payment amount. The Precertification Specialist I maintains a resource schedule and acts as a liaison with the patient, provider, physician, and insurance companies.

• Ensures completeness and integrity of patient registration
  • Verifies and documents patient demographics, guarantors, and insurance information
  • Validates correct insurance at the time of registration and maintains a 4% or less error rate
  • Completes the pre-admission processes specific to assignment
  • Monitors schedules of assigned areas for added tests or procedures
  • Documents all accounts with pertinent information not limited to follow-up needed by hospital personnel
• Performs financial processes and communicates patient's responsibility
  • Creates estimates of charges based on available information and collects pre-payments when necessary
  • Communicates financial options to patients prior to testing with possible referral to Financial Counselors
  • Screens testing urgency based on patient's ability to pay
  • Balances cash sheets and audits
  • Assures the MHG financial policy qualifications are met
  • Monitors authorization status and alerts Provider Staff or Precertification Specialist II if not received at least 3 days prior to date of service
  • Obtains copies of authorizations for non-MHG providers to receive reimbursement for MHG
  • Communicates with provider to modify testing/procedure orders to a medically necessary diagnosis based on payer guidelines
  • Education Requirement
  • Required: High School Diploma or GED equivalent
  • Preferred: Certification or vocational training
  • Experience Requirement
  • Required: Minimum of one year previous clerical experience
  • Preferred: Minimum years of relevant experience 2-4