Pre Services Representative - Patient Financial Services | Full Time | Days

Concord Hospital; Concord (NH); On-site; USD 25,000 - 36,000; Full time

Job summary

Concord Hospital in Concord, NH is seeking a Pre Services Representative responsible for pre-service scheduling, patient access, pre-registration, insurance verification, financial clearance and denial management.

Full-time 40 hours/week, 8:30 am–5:00 pm, with flexibility to stay until 6 pm; located at S. Main Street Concord.

Requires a high school diploma, strong communication, knowledge of insurance policies, and ability to work in a team.

Qualifications

• Must have knowledge of insurance policies, coverage, and prior authorization requirements.
• Minimum of three years in a healthcare or related environment.
• Strong communication, critical thinking, problem-solving, and interpersonal skills.
• Ability to work in a 16+ member team and independently.

Responsibilities

• Authorize insurance for elective outpatient radiology imaging and testing.
• Schedule, reschedule, and cancel appointments; enter data per guidelines.
• Handle calls professionally; adhere to department standards.
• Verify benefits and approvals for outpatient imaging and procedures.
• Notify payers of admissions/observation as required.
• Manage faxes in the Work Queue Monitor.
• Communicate with patients, providers, payers, and partners to schedule and bill.
• Research requests for cost of care.

Skills

Insurance policies

Prior authorization

Microsoft Office

Windows navigation

Communication skills

Critical thinking

Interpersonal skills

Education

High school diploma or GED

Tools

Microsoft Office

Windows OS

Job description

Summary

The Pre Services Representative is engaged in one or more of the revenue cycle roles including: pre-service scheduling and patient access, pre-registration, insurance verification, financial clearance and denial management.

Hours

Full time 40 hours/week, 8:30a - 5:00p. Candidate must have flexibility to work until 6pm as needed. The position is located at our S. Main Street Concord location.

Education

High school diploma or equivalent (GED).

Responsibilities

• - Performs insurance auth o rization for elective outpatient radiology imaging and cardiovascular testing.
• - Schedules, resc h edules and cancels appointments and enters data into Schapptbook accordingto program logic and Scheduling Guidelines.
• - Handles phone calls in a professional and efficient manner adhering to department call stan d ards for Pre Services.
• - Using appropriate schedules and work lists verifies insurance benefits and approvals for outpatient imaging, elective procedures and surgical cases and urgent/emergent admissions.
• - Notify Payers of patient admissions/placed in observation as required by payers.
• - Manages Faxes received in the Work Queue Monitor Program.
• - Communicates and responds to patients, provider(s), payers and other associates/business partners and joint ventures using available tools (Message Center in PowerChart, email/secure email or phones) to ensure accurate scheduling of appointments and billing of encounters
• - Researches and responds to requests for cost of care.

Required Experience

Must have prior knowledge and expertise in insurance policies and coverage and medical necessity and prior authorization requirements. Minimum of three years experience in a healthcare or related environment also required. Working knowledge of medical terminology, Microsoft Office applications and the ability to navigate in a Windows based environment. Must have proven exceptional communication skills, critical thinking and problem solving skills, and interpersonal skills. The successful candidate will be part of a 16 plus member team so must be able to work well in a team environment and possess ability to work independently as well.

Concord Hospital is an Equal Employment Opportunity employer. It is our policy to provide equal opportunity to all employees and applicants and to prohibit any discrimination because of race, color, religion, sex, sexual orientation, gender, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status.

Know Your Rights: Workplace Discrimination is Illegal

Applicants to and employees of this company are protected under federal law from discrimination on several bases. Follow the link above to find out more.

If you are an individual with a disability and require a reasonable accommodation to complete any part of the application process, you may contact Human Resources at 603-230-7269.

The physical demands and characteristics of the work environment described here are representative of those that will be encountered by an employee to successfully perform the essential functions of this job.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The Dictionary of Occupational Titles Material Handling Classification is SEDENTARY. The employee must regularly lift, carry or push/pull less than 10 pounds, frequently lift, carry or push/pull less than 10 pounds, and occasionally lift, carry or push/pull up to 10 pounds.

While performing the duties of this Job, the employee is regularly required to do repetitive motion, hear, and sit. The employee is frequently required to do fine motor, reach, and speak.

Specific vision abilities required by this job include far vision, and near vision.

The employee is occasionally exposed to moving mechanical parts.

The noise level in the work environment is usually moderate.