Pre-Services Representative

Adventist Health; United States; On-site; USD 40,000 - 60,000; Full time

Job summary

Adventist Health is seeking a dedicated professional for the role focused on obtaining and verifying patient information, managing financial responsibilities, and ensuring a positive patient experience. The position entails pre-registering patients, verifying insurance, and educating them about the financial process. Required qualifications include a High School Education/GED, with preferred experience in healthcare front office roles and customer service. This role is essential for maintaining compliance and providing excellent patient care in the Roseville, California area.

Qualifications

• High School Education/GED or equivalent required.
• Associate's/Technical Degree or equivalent combination preferred.
• Healthcare front office experience preferred.
• Customer service experience preferred.

Responsibilities

• Completes patient packets with all necessary forms and documents.
• Assists customers with Medicaid/County Medical Services Program applications.
• Maintains and updates patient accounts for financial eligibility.
• Obtains necessary authorizations for inpatient stays.
• Performs other job-related duties as assigned.

Skills

Healthcare front office experience

Customer service experience

Education

High School Education/GED

Associate's/Technical Degree

Job description

Job Description

Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters has been based in Roseville, California, for more than 40 years.

Job Summary

Obtains and verifies demographic, confidential clinical and financial information necessary to accurately and efficiently financially secure hospital procedures in a timely fashion. Pre-registers patients, verifies insurance eligibility and benefits, and identifies services that require authorization, notification or recertification. Completes medical necessity review, determines estimated financial responsibility, communicates it to patients and collects payment. Adheres to all JCAHO, CMS, and HIPAA requirements when creating a hospital account. Works directly with nurses, medical staff, ancillary departments, insurance carriers, and external professionals to assist patients with obtaining healthcare and financial services and educates patients through the process to provide a positive patient experience.

Job Requirements

• High School Education/GED or equivalent: Required
• Associate's/Technical Degree or equivalent combination of education and related experience: Preferred
• Healthcare front office experience: Preferred
• Customer service experience: Preferred

Essential Functions

• Completes patient packets with all necessary forms and documents in preparation for admissions and coordinates admissions activities to obtain all necessary patient information for billing and other departments.
• Assists customers with Medicaid/County Medical Services Program (CMSP) applications by evaluating documentation, monitoring compliance, and establishing county welfare office appointments.
• Maintains and updates patient accounts for medical and financial eligibility and maintains reports related to case qualifications; obtains necessary billing, insurance and demographic information.
• Obtains necessary authorizations for inpatient stays from utilization review, posts payments and contractual adjustments, serves as a resource for public insurance information and benefits, and sets up payment schedules for patients unable to pay balances in full.
• Performs other job-related duties as assigned.

Organizational Requirements

Adventist Health is committed to the safety and well-being of associates and patients. All associates must receive required vaccinations as a condition of employment and annually thereafter, where applicable, with medical and religious exemptions possible. Adventist Health participates in E-Verify. By applying you acknowledge that you have accessed and read the E-Verify Participation and Right to Work notices and understand their contents.