Preservice Specialist I - (FT, Days)

Nuvance Health; Danbury (CT); Hybrid; USD 25,000 - 36,000; Full time

Benefits offered by this job

PTO

Medical coverage

FSA

HSA

401(k)

Life insurance

Wellness program

Employee assistance

Job summary

Nuvance Health in Danbury, CT is seeking a full-time Patient Access/Financial Clearance specialist to facilitate scheduling, registration and insurance verification. The hybrid-remote role includes an initial on-site period for 90 days and supports physician offices and patients to ensure accurate demographics and timely reimbursement.

Responsibilities include coordinating referrals, obtaining authorizations, estimating patient liabilities with tools, and guiding patients through

Qualifications

• HS Diploma required; NAHAM certification within 1 year of hire.
• Basic MS Word and MS Excel; strong customer service and organizational skills.
• Associate’s degree preferred with 6 months related experience.

Responsibilities

• Schedule patients for hospital or medical group services via phone, online requests, or outbound to patients.
• Work in referral management to schedule in-system and external referrals for NHMP practices.
• Provide excellent customer service to physician offices and patients; reduce call times.
• Verify insurance eligibility and calculate patient liabilities using estimator tools.
• Initiate authorizations, pre-certifications, notices of admission, and referrals; follow up with payers.
• Conduct pre-registration with demographic/insurance verification and liability collection.

Skills

Customer service

Communication

Organization

MS Word

MS Excel

Education

HS Diploma

NAHAM certification within 1 year

Associate degree preferred

Tools

MS Word

MS Excel

Job description

Full Time: Monday-Friday 9:00am-5:30pm. Hybrid-Remote. First 90 days on-site in Danbury, CT.

Northwell is the largest not-for-profit health system in the Northeast, serving residents of New York and Connecticut with 28 hospitals, more than 1,000 outpatient facilities, 22,000 nurses and over 20,000 physicians. Northwell cares for more than three million people annually in the New York metro area, including Long Island, the Hudson Valley, Connecticut and beyond, thanks to philanthropic support from our communities. Northwell is New York State’s largest private employer with over 104,000 employees — including members of Northwell Health Physician Partners — who are working to change health care for the better.

Summary:

Facilitates patient flow through the referral, scheduling, and financial clearance process. Responsible for obtaining demographic and financial information to ensure accurate patient identification and to secure reimbursement. Performs pre-registration functions and insurance eligibility verification. Provides estimates for services. Requests and secures payments.

Responsibilities:

1. 1.May be assigned to schedule patients for hospital or medical group services by incoming phone calls, online requests, or outbound to patients.
2. 2.May be assigned to work within the central referral management system to identify and schedule specialist and primary care referrals to NHMP practices as well as external providers when appropriate, with the goal of promoting in-system retention of patients and continuity of care.
3. 3.Provides excellent customer service both to physician offices and patients. Contributes to reduction of abandoned call rate, length of calls, and average speed answered through use of best practices and workflow improvements as defined by management. Receives incoming faxed physician orders. Verifies orders for compliance and accuracy.
4. 4.Performs insurance eligibility verification and executes payer requirements as needed. Obtains accurate insurance benefit information from payers, such as deductible, copay, and coinsurance amounts. Utilizes patient estimation tool to calculate estimate of patient liabilities. Requires an understanding of coding, procedural protocols and the charge description master.
5. 5.Initiates requests for authorizations, pre-certifications, notices of admission, and referrals from insurance companies. Follows up with payers and providers to ensure that authorizations are in place. Takes appropriate steps to remediate situations in which financial clearance is not completed to ensure that Nuvance Health receives prompt payment for services rendered.
6. 6. Contacts patients to perform pre-registration, including demographic verification, conveyance of insurance benefits, and estimates of liabilities. Collects on such liabilities prior to time of service utilizing provided scripting. Refers patients who express financial hardship to Financial Counseling for a financial assessment.
7. 7. Safeguards patient confidentiality by adhering to all department, organization, state, and federal compliance guidelines. Fulfills all compliance responsibilities related to the position.
8. 8. Performs other duties as assigned.

Education Skills Experience:

HS Diploma Required. Minimum of 2-year job-related experience National Association of Healthcare Access Management (NAHAM) certification within one year of hire Basic MS Word & MS Excel. Customer service and organizational skills. Associate's degree Preferred with 6 months job-related experience - Preferred.

Working Conditions:

• Manual: Some manual skills/motor coord & finger dexterity
• Occupational: Little or no potential for occupational risk
• Physical Effort: Sedentary/light effort. May exert up to 10 lbs. force

Company: Nuvance Health
Org Unit: 2071
Department: Corporate Financial Clearance
Exempt: No
Salary Range: $18.13 - $26.00 Hourly

Available benefits include: Paid Time Off (PTO); Medical, Dental and Vision Coverage; Health and Dependent Care Flexible Spending Accounts; Health Savings Account; 401(k) Retirement Plan; Basic Life and AD&D insurance; Wellness Programs; Employee Assistance Program; and Team Member Discounts. Available benefits for union positions may vary in accordance with applicable Collective Bargaining Agreements.