Obtains complete and accurate patient demographic, insurance (eligibility and/or verification), and financial information and collects all liability due for scheduled patients by telephone.
Pre-registers patients. Confirms, enters, and/or updates all required demographic data on patient and guarantor on registration system. Avoids overlays and duplicate patient medical records. Verifies insurance to determine coordination of benefits and obtains authorization and/or referrals as required. Screens for and processes non-covered services and waiver of liability (ABN) through automated screening at time of service. Completes the Medicare Secondary Payer (MSP) questionnaire when applicable.
Identifies copay and deductibles. Communicates patient financial responsibility to patient prior to date of service. Collects patient responsibility prior to service. copies of insurance card(s), forms of ID, and signature(s) on all required forms. Verifies information on appropriate accounts to determine insurance coordination of benefits, pre-certification/prior-authorization if not verified by PASC. Completes the Medicare Secondary Payer (MSP) questionnaire when applicable. Verifies insurance to determine coordination of benefits and obtains authorization and/or referrals as required. Screens for and processes non-covered services and waiver of liability (ABN) through automated screening at time of service.
Informs self-pay patients of liability due, prepayment requirements and coordinates screening of alternate funding sources if applicable. Refers potentially eligible patients to financial counseling and/or contract eligibility vendor(s).
Collects patient payments and provides accurate receipt. Posts all payments in system. Reconciles receipts with cash collected and completes required balancing forms. Documents patient account notes for all interactions/transactions.
Maintains departmental and/or individual work queues and reports as required. Explains/answers patient billing inquiries and interprets statement data to resolve accounts. Escalates account issues which cannot be resolved. Reviews input and audits quality to assure accuracy in all aspects of the position, particularly patient type, financial class and insurance codes.
Meets departmental productivity and quality standards.
Promotes mission, vision, and values of SCL Health, and abides by service behavior standards.
Perform other duties as assigned.
Education: Required High School Diploma or Equivalent
Experience: Preferred Previous hospital/medical office, medical insurance and/or customer service experience
Knowledge Skills and Abilities:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements list must be representative of the knowledge, skills, minimum education, training, licensure, experience, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Ability to manage workload in high volume environment.