Pre-Registration Representative

As the Pre-Registration Representative, you will be responsible for:

• Pre-registers and pre-admits patients by telephone and/or in person
• Review and interpretation of insurance benefits, cash collections, interaction with public assistance programs (i.e. Medi-Cal, CCS)
• Implementation of Medicare requirements
• Collection of accurate demographic information and interaction with physicians/office personnel as well as other hospital personnel (i.e., PTU, IOU, nursing units)
• Interact with hospital departments such as Insurance Verification, Financial Counseling, Utilization Review and Patient Business Services to ensure correct and timely reimbursement

We’re seeking a self-directed, detail-oriented professional with:

• Knowledge of ICD-10, CPT-4, and HCPCS codes as applied to authorization submission and claims reimbursement
• Knowledge of authorization submission and reimbursement for high cost specialty services and medication administration
• Knowledge of medical terminology to sufficiently identify various procedures to obtain optimum benefit information and reimbursement
• Knowledge of third party payor verification terminology
• Knowledge of State and Federal programs to ensure reimbursement from Medicare, Medi-Cal, CCS programs, out-of-state Medicaid, or other sponsoring agencies
• Knowledge of healthcare insurance and medication prior authorization & basic working knowledge of coding
• Strong oral and written communications skills
• Skill in typing proficiently including 10-key, focusing on accuracy and speed

Note: May be subject to test on qualifying skills