THIS INDIVIDUAL WILL FLOAT TO MULTIPLE AREAS OF THE BUSINESS OFFICE INCLUDING INSURANCE VERIFICATION/COLLECTIONS, SURGERY SCHEDULING AND RECEPTION.
INSURANCE VERIFICATION:
- Review patient information, verifying patient information is accurate (spelling of name, D.O.B., gender, etc.).
- Verifies patient insurance benefits by contacting insurance companies and interpretation of managed care contracts. Determines pre-certification requirements
- Verify insurance benefits by reviewing our contract and patient’s quoted benefits..
- Determine co-pay. Post all insurance and billing comments. Enter all information into patient accounting system.
- Contact patients regarding moneys due prior to date of surgery.
- Assists patients with credit agreements (Care Credit).
- Determine patient responsibility for cash payment based on reimbursement and account reviews.
- Review financial records for correctness.
- Determine patient responsibility for cash payment based on reimbursement and account reviews.
- Attach correct documentation to verification sheets and delivering to appropriate staff.
- Other duties as assigned.
SURGERY SCHEDULING:
- Schedule surgeries, coordinates schedule between Surgery Center and doctor’s offices.
- Gathers all detailed information for the patient’s chart, such as type of procedure, supplies, special equipment required, insurance information, etc. Enters all patient information in computer system.
- Schedules all surgical anesthesia services required according to doctor preference and availability.
- Assures that pre-certification/referrals are in order for Insurance Coordinator.
- Completes billing packets for CSO on a daily basis.
- Confers with OR Nurse Manager, Charge Nurse and /or Administrator to determine status of scheduled surgeries. Alters schedules to meet unforeseen conditions.
- Works closely with the Administrator and CSO Credentialing person when maintaining approved privileges for each physician or as documents are updated, etc.
- Other duties as assigned.
FRONT DESK / RECEPTION:
- Ensures all required forms are placed in designated areas of the patients chart
- Daily preparation of charts for next day’s surgeries within required deadline (NO LESS than 3 days prior to surgery, for all cases scheduled four days or more in advance of surgery date)
- Preparation of medical consents for each chart prepared
- Labeling necessary documents and adding physician orders
- Out-bound collection calls to patients regarding their medical invoice/bill answering questions and setting up payment/payment plans.
- Utilization of various collection strategies and methodologies to contact consumers in order to negotiate payment in full or payment arrangements on debt within federal, state and client collection guidelines and laws.
- Knowledge of health care financing and Medical Collections preferred
- Other duties as assigned
Required Skills
REQUIRED SKILLS:
- High school diploma or equivalent.
- Minimum 2 years' previous experience in insurance verification, collections, verification, billing, reception, admissions, etc.
- Surgical experience strongly preferred.
- Medical Terminology knowledge required.
- Communication skills: ability to effectively present information to patients, physicians, and other employees of surgery center.
- Basic math skills.
Required Experience