Pre-Services Specialist I- New Berlin Aurora Health Care 595 reviews - New Berlin, WI 53151 How You'll Make a Difference: Completes pre-registration and financial clearance functions prior to the patient?s arrival for service. Collects and validates accurate patient demographic and insurance information, obtains pre-certification/authorization as required and enters all necessary information into Aurora Health Care System (EPIC). Informs the patient of his/her approximate liability, collects patient liabilities, identifies patients in need of financial assistance and refers patients to financial counseling as necessary. Contacts the patient to obtain/validate demographics and insurance information. Completes insurance verification and eligibility checks and documents patient liability. Collects and accurately documents initial pre-certification/authorization information if available. Initiates the process for obtaining a required referral/authorization if not obtained. Calculates patient liabilities based on scheduled procedures and previous balances. Informs the patient of his/her liability and discusses financial obligations with the patient including requesting payment. Communicates to physician office/patient the organization expectation of payment and/or having an authorization on file prior to service, explaining service may be re-scheduled. Schedule patient visits using guidelines established within scheduling system. Recognizes exceptional scheduling situations and escalates as necessary. Completes necessary online EPIC questionnaires needed to complete scheduled exam. Provides accurate, detailed information regarding test preparations, time of patient arrival and any other directional information. Works assigned EPIC Scheduled Order Work Queue, following the department?s work flow process on appropriately transferring, deferring or removing orders from the work queue. Proactively communicates issues involving customer service and process improvement opportunities to management. Maintains excellent public relations with patients, families and clinical staff as well as demonstrates a willingness and ability to work collaboratively with others for concise and timely flow of information. Maintains knowledge of and reference materials for Medicare, Medicaid and third-party payer requirements, guidelines and policies, insurance plans requiring pre-authorization/referral and a list of current accepted insurance plans. What it Will Take: Licenses & Certifications None Required. Degrees High School Graduate. Required Functional Experience Typically requires 1 year of experience in health care, insurance industry, call center or customer service setting. Knowledge, Skills & Abilities Demonstrated ability to identify and understand issues and problems. Examines data and draws logical conclusions based on information available.Knowledge and ability to articulate explanations of Medicare/HIPAA/EMTALA rules and regulations and comply with updates on insurance pre-certification requirements.Mathematical aptitude, effective communication skills and critical thinking skills.Understanding of basic human anatomy, medical terminology and procedures for application in the patient referral/pre-certification/authorization processes.Ability to read and interpret documents such as safety rules, operating and maintenance instructions and procedure manuals. Ability to speak effectively to customers or employees of organization, maintaining a pleasant, professional demeanor.Ability to handle sensitive and confidential information according to internal policies.Ability to problem solve in a high profile and high stress area, working independently to set and meet deadlines and prioritize work.Demonstrated technical proficiency including experience with insurance verification/eligibility tools, EPIC electronic medical record, patient liability estimation tools, Microsoft Office, Internet Explorer and phone technology. What We'd Love to See: Prefer candidates with prior experience in Pharmacy or with Specialty medications Strong focus on Customer service Scheduled Hours: Monday through Friday 09:30AM until 06:00PM Department: Preservice Unit 2 Location Address: 12695 W National Ave New Berlin, WI 53151-4057 Waukesha At Aurora Health Care: At Aurora Health Care we pride ourselves on taking care of our people. And not just our patients?we mean you, too. We help each other live well. When you work at Aurora, you get the chance to work with a dedicated team thats as passionate about the work as you are. Here, youll find limitless opportunities for ongoing learning, career advancement, competitive compensation and a stable work environment. But more than that, you have the opportunity to change lives?including your own. Diversity and inclusion matters at Aurora. We celebrate our differences and nurture an environment where everyone feels included. We know that when we reflect the communities we serve, when we embrace differences and bring our whole selves to work every day, we are working as one to build a healthier tomorrow for everyone. Aurora supports a safe, healthy and drug-free work environment through criminal background checks and pre-employment drug testing. We maintain a smoke-free environment at all our locations. 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