Pre-Registration/Insurance Verification Representative

OU Health; United States; Remote; USD 35,000 - 50,000; Full time

Job summary

OU Health is seeking a Pre-Registration/Insurance Verification Representative for a full-time remote position. The individual will be responsible for conducting timely insurance verifications and managing patient information to ensure compliance and quality service. Candidates should possess strong communication skills and detailed knowledge of insurance processes, with a minimum educational requirement of a high school diploma.

Benefits

Comprehensive benefits package

PTO

401(k)

Medical and dental plans

Qualifications

• 0-3 years experience required, insurance verification experience preferred.
• Communication skills necessary.
• Proficiency in PC applications required.

Responsibilities

• Responsible for timely and accurate pre-registration and insurance verification.
• Performs verification tasks and resolves issues with referrals.
• Meets/exceeds performance expectations within required time frames.

Skills

Communication

Customer orientation

Interpersonal skills

PC skills

Basic skills

Education

High school diploma or GED

Job description

Pre-Registration/Insurance Verification Representative

Pay Competitive

Location Remote

Employment type Full-Time

Job Description

Req#: R0055833
Position Title:
Pre-Registration/Insurance Verification Representative
Department:
Admitting
Job Description:

General Description: Responsible for timely and accurate pre-registration and insurance verification. Accurately interprets managed care contracts.

Essential Responsibilities:

• Performs pre-registration and insurance verification within 24 hours of receipt of reservation/notification for both inpatient and outpatient services
• Follows scripted benefits verification and pre-certification format in Meditech custom benefits screen and record benefits and pre-certification information therein
• Contacts physician to resolve issues regarding prior authorization or referral forms
• Assigns plans accurately
• Performs electronic eligibility confirmation when applicable and document results
• Researches Patient Visit History to ensure compliance with payor specific payment window rules
• Completes Medicare Secondary Payor Questionnaire as applicable for retention in Abstracting module
• Calculates patient cost share and be prepared to collect via phone or make payment arrangement
• Contacts patient via phone (with as much advance notice as possible, preferably 48 hours prior to date of service) to confirm or obtain missing demographic information, quote/collect patient cost share, and instruct patient on where to present at time of appointment
• Receives and records payments from patient for services scheduled.
• Utilizes appropriate communication system to facilitate communication with hospital gatekeeper
• Performs insurance verification and pre-certification follow up for prior day’s walk in admissions/registrations and account status changes by assigned facility
• Communicates with hospital based Case Manager as necessary to ensure prompt resolution of pre- existing, non-covered, and re-certification issues
• Utilizes Meditech account notes and Collections System account notes as appropriate to cut and paste benefit and pre-authorization information and to document key information
• Meets/exceeds performance expectations and completes work within the required time frames
• Implements and follows system downtime procedures when necessary
• Practices and adheres to the “Code of Conduct” philosophy and “Mission and Value Statement”

General Responsibilities:

• Other duties as assigned

Minimum Qualifications:

Education: High school diploma or GED required

Experience: 0-3 years experience; At least three years of insurance verification experience preferred

License(s)/Certification(s)/Registration(s) Required: N/A

Knowledge, Skills and Abilities:

• Communication - communicates clearly and concisely, verbally and in writing
• Customer orientation - establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations
• Interpersonal skills - able to work effectively with other employees, patients and external parties
• PC skills - demonstrates proficiency in PC applications as required
• Policies & Procedures - demonstrates knowledge and understanding of organizational policies, procedures and systems
• Basic skills - able to perform basic mathematical calculations, balance and reconcile figures, punctuate properly, spell correctly and transcribe accurately
Current OU Health Employees - Please click HERE to login.
OU Health is an equal opportunity employer. We offer a comprehensive benefits package, including PTO, 401(k), medical and dental plans, and many more. We know that a total benefits and compensation package, designed to meet your specific needs both inside and outside of the work environment, create peace of mind for you and your family.

About the company

OU Health is the combination of OU Medical Center – Oklahoma City & Edmond, the Children's Hospital, OU Physicians, OU Children's Physicians, the University of Oklahoma College of Medicine, and the Peggy and Charles Stephenson Oklahoma Cancer Center.

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