Pre-Clearance Coordinator

J Arthur Dosher memorial hospital; Southport (NC); On-site; USD 38,000 - 46,000; Full time

Job summary

J Arthur Dosher memorial hospital is seeking a Pre-Clearance Coordinator in North Carolina to review physician orders for accuracy, obtain insurance authorizations, and pre-register patients before tests and procedures.

The role includes verifying patient demographics, determining benefits and costs, and collecting applicable payments prior to procedures, ensuring compliance with HIPAA and regulatory standards.

Qualifications

• Education: High school graduate or equivalent.
• Experience in medical office or hospital settings is required.
• Knowledge of HIPAA and patient confidentiality is essential.

Responsibilities

• Review incoming orders for accuracy and insurance compliance.
• Perform eligibility and benefits checks to verify coverage and costs.
• Obtain or verify prior authorizations for tests/procedures.
• Register patients with signatures and forms per regulations.
• Communicate estimated financial obligations to patients prior to procedures.

Skills

Follow instructions

Regulatory standards

HIPAA compliance

Coordination skills

Emergency response

Medical terminology

Education

High school diploma

Job description

Description

Responsible for reviewing physician orders for accuracy, obtaining necessary insurance authorizations and pre- registering patients prior to tests and procedures. The Pre-Clearance Coordinator will obtain or verify individual identifying and demographic data for the patient’s permanent medical record. The Pre-Clearance Coordinator will determine patient benefits and eligibility and advise and collect from patient all applicable estimated costs prior to procedure.

Functions of the Position (not an exhaustive list):

• Review incoming orders for accuracy and compliance with insurance and Dosher guidelines
• Perform eligibility and benefits check to accurately verify patient’s active coverage and determine potential costs and authorization needs associated with patient’s treatment
• Obtain or verify necessary prior authorizations are on file for tests/procedures
• Register patients efficiently and accurately by obtaining signatures, complete all required forms and provide patient’s information as required by state and federal regulations
• Communicate estimated financial obligations with patient prior to procedure and collect applicable monies due prior to procedure or coordinate payment arrangements

Requirements

Qualifications

Education:

• High school graduate or equivalent
• Medical office or Hospital experience required =

Necessary skills:

• Ability to comprehend and follow instructions
• Familiarity with Regulatory Standards
• Maintain strictest confidentiality and adhere to all HIPAA guidelines/regulations
• Ability for rapid mental/muscular coordination simultaneously
• Ability to perform in emergency situations
• Knowledge of basic medical terminology

Physical Demands:

• Requires sitting for long periods, sometimes in a confined space
• Lifting/carry up to 30 lbs
• Repetitive finger movement
• Repetitive twisting and pressure involving hand and finger mobility
• Reaching at all levels
• Stooping, bending, kneeling, or crouching
• Possible exposure to bloodborne pathogens
• Work with machinery with moving parts

Protective Equipment Required:

• PPE as required