What are the responsibilities and job description for the PreService Representative position at USA Health Systems?
Overview
USA Health is Transforming Medicine along the Gulf Coast to care for the unique needs of our community.
USA Health is changing how medical care, education and research impact the health of people who live in Mobile and the surrounding area. Our team of doctors, advanced care providers, nurses, therapists and researchers provide the region's most advanced medicine at multiple facilities, campuses, clinics and classrooms. We offer patients convenient access to innovative treatments and advancements that improve the health and overall wellbeing of our community.
Responsibilities
Abides by and enforces all compliance requirements and policies and performs these responsibilities in an ethical manner consistent with the organization’s values; adheres to hospital policies including confidentiality; requires minimal supervision to safely perform essential functions; utilizes proper body mechanics when moving equipment and supplies that are necessary to perform essential functions; reports broken or malfunctioning equipment to supervisor or manager; initiates requests, follows up to provide additionally required information, tracks progress, expedites responses from insurance carriers and other payers, and maintains contact with patients, departments and providers to keep them continuously informed; tracks, reports, and escalates service issues arising from requests for authorizations, financial assistance or other issues that delay service, to ensure patient access and to avoid delays that may interrupt care of therapies; obtains clinical, lab and medical testing documentation from at least two EMR’s and from paper documentation for submission to payers; interacts with all necessary portals to submit authorization requests electronically to receive as timely of responses as possible, using websites and telephone services as needed; participates in regular group discussions regarding effectiveness of service by reviewing results, including any denials for reason under the purview of this position; participates in work-group discussions and on committees as assigned; participates in Performance Improvement activities as assigned; regular and prompt attendance; ability to work the schedule as defined and overtime as required; related duties as required.
Qualifications
High school diploma or equivalent and two years of insurance verification and/or precertification experience in a medical office or hospital setting.
