Pre-Services Coordinator

Marion County Public Health Department; Indianapolis (IN); On-site; USD 45,000 - 58,000; Full time

Job summary

A leading public health organization seeks a Pre-Services Coordinator in Indianapolis to manage patient interactions, insurance verifications, and financial responsibilities. This role is essential in creating a positive first impression and ensuring a smooth patient experience, ideally suited for candidates with relevant degree or extensive experience in healthcare settings.

Qualifications

• Bachelor's degree or 4 years of experience in a pre-services setting required.
• Certification in Healthcare Business Insights within 60 days of hire.

Responsibilities

• Conducts pre-registration functions and validates patient data.
• Verifies insurance information and coordinates benefits.
• Counsels patients about insurance benefits and payment options.

Skills

Understanding of Medicare regulations

Advanced computer skills

Education

Bachelor's degree or equivalent experience

Job description

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Eskenazi Health serves as the public hospital division of the Health & Hospital Corporation of Marion County. Physicians provide a comprehensive range of primary and specialty care services at the 333-bed hospital and outpatient facilities both on and off of the Eskenazi Health downtown campus, including at a network of Eskenazi Health Center sites located throughout Indianapolis.

FLSA Status

Non-Exempt

Job Role Summary

The Pre-Services Coordinator works directly with patients, referring physician offices, and payers to ensure full payer clearance prior to receiving care. This involves pre-registration, financial clearance, authorization, referral validation, and pre-service estimations and collections. The role establishes the first impression of Eskenazi Health for patients, families, and external/internal customers, serving as a subject matter expert on payer requirements, authorizations, appeals, and patient navigation.

Essential Functions and Responsibilities

• Conducts pre-registration functions, validates patient demographic data, identifies and verifies medical benefits, accurate plan codes, and Coordination of Benefits orders.
• Corrects and updates necessary data to ensure timely and accurate bill submission.
• Maintains accountability for data accuracy entered into systems and demonstrates the ability to pass monthly audits.
• Verifies insurance information through payer contacts via telephone, online resources, or electronic verification systems; identifies payer authorization/referral requirements.
• Provides documentation and follow-up to patients, physician offices, case management departments, and payers regarding authorization/referral deficiencies.
• Contacts insurance carriers or other sources to obtain prior authorizations; secures pre-certification and/or authorization before services.
• Identifies all patient financial responsibilities, calculates estimates, collects liabilities, posts payments, and completes waivers as appropriate in the Epic system.
• Identifies self-pay and complex liability calculations; escalates accounts to Financial Counselors as needed.
• Counsels patients regarding insurance benefits, explaining financial responsibilities, payment options, and collections procedures.
• Communicates effectively with designated contacts to exchange information and promote positive working relationships.
• Initiates collection processes for prepayments and performs follow-up to maximize collections.
• Updates and documents information accurately in Epic.
• Attains productivity and quality standards, recommending improvements when appropriate.

Job Requirements

Accredited Bachelor's degree OR four (4) years experience in a pre-services setting, along with a High School Diploma or GED.

• Certification in Healthcare Business Insights within 60 days of hire.

Knowledge, Skills & Abilities

• Understanding of Medicare regulations, Medicaid MRO, Medicaid Clinic Services, and Commercial insurance related to prior authorization processes.
• Advanced computer skills for web-based applications.

Eskenazi Health is accredited by The Joint Commission, recognized as one of Indiana’s best employers by Forbes, and the top hospital in Indiana for community benefit by the Lown Institute. The hospital is home to several firsts in Indiana, including the first adult Level I trauma center, the only verified adult burn center, and the Sandra Eskenazi Mental Health Center.