Pre-Registration Representative

University of California - Los Angeles Health; Los Angeles (CA); On-site; USD 41,000 - 61,000; Full time

Job summary

University of California - Los Angeles Health is seeking a Pre-Registration Representative to handle patient pre-registration and pre-admission, review insurance benefits, and ensure accurate demographic collection. The role requires coordinating with hospital departments to ensure timely reimbursement and adherence to Medicare requirements.

Strong communication and medical terminology knowledge are essential.

Qualifications

• Knowledge of ICD-10, CPT-4, and HCPCS codes for authorization submission and claims reimbursement.
• Knowledge of authorization submission and reimbursement for high-cost specialty services and medication administration.
• Knowledge of medical terminology to identify procedures for benefit information and reimbursement.
• Knowledge of third party payor verification terminology.
• Knowledge of State and Federal programs to ensure reimbursement from Medicare, Medi-Cal, CCS, and other agencies.
• Knowledge of healthcare insurance and medication prior authorization & basic coding.
• Strong oral and written communications skills.
• Typing proficiently including 10-key, emphasizing accuracy and speed.

Responsibilities

• Pre-registers and pre-admits patients by telephone and/or in person.
• Review and interpretation of insurance benefits, cash collections, interaction with public assistance programs (Medicaid, CCS).
• Implementation of Medicare requirements.
• Collection of accurate demographic information and interaction with physicians/office personnel and hospital staff (PTU, IOU, nursing units).
• Collaborate with Insurance Verification, Financial Counseling, Utilization Review and Patient Business Services to ensure correct reimbursement.

Skills

ICD-10, CPT-4, HCPCS codes

Authorization submission & reimburse

Medical terminology

Third-party payor terminology

Medicare/Medi-Cal/CCS programs

Prior authorization & coding basics

Communication skills

Typing (10-key)

Job description

Description

As the Pre-Registration Representative, you will be responsible for:

• Pre-registers and pre-admits patients by telephone and/or in person
• Review and interpretation of insurance benefits, cash collections, interaction with public assistance programs (i.e. Medi-Cal, CCS)
• Implementation of Medicare requirements
• Collection of accurate demographic information and interaction with physicians/office personnel as well as other hospital personnel (i.e., PTU, IOU, nursing units)
• Interact with hospital departments such as Insurance Verification, Financial Counseling, Utilization Review and Patient Business Services to ensure correct and timely reimbursement

Salary Range: $30.36-$43.49 /hourly

Qualifications

We're seeking a self-directed, detail-oriented professional with:

• Knowledge of ICD-10, CPT-4, and HCPCS codes as applied to authorization submission and claims reimbursement
• Knowledge of authorization submission and reimbursement for high cost specialty services and medication administration
• Knowledge of medical terminology to sufficiently identify various procedures to obtain optimum benefit information and reimbursement
• Knowledge of third party payor verification terminology
• Knowledge of State and Federal programs to ensure reimbursement from Medicare, Medi-Cal, CCS programs, out-of-state Medicaid, or other sponsoring agencies
• Knowledge of healthcare insurance and medication prior authorization & basic working knowledge of coding
• Strong oral and written communications skills
• Skill in typing proficiently including 10-key, focusing on accuracy and speed

Note: May be subject to test on qualifying skills