Location(s): 700 Ackerman Road, Columbus
The Financial Clearance Representative interacts with patients and/or their representatives to perform patient pre-registration in a central scheduling environment. Obtains accurate information including demographic, physician, insurance, employment and other miscellaneous information. Screens physician’s orders and pre-registration data for changes and compliance with payer requirements for medical necessity and pre-certification. Reviews and completes changes to third party eligibility and benefits verification and coordinates with insurance carriers and 3rd party entities. Accurately enters and/or updates all required data in EPIC computer systems to update accounts.
Requirements: Associates degree or higher, or high school diploma/GED with 2+ years of experience in insurance, healthcare, or related field. Excellent customer service skills coupled with enthusiasm and compassion along with the ability to multitask working in a fast paced environment. Excellent verbal and written communication skills. High level of interpersonal skills to handle sensitive, confidential situations and establish effective working relationships with patients, physicians, team members, and others throughout the clinic. Attendance, promptness, professionalism, the ability to pay attention to detail, cooperativeness with physicians, co-workers and supervisors, and politeness to customers, vendors, and patients. Ability to escalate registration issues if necessary. Knowledge and understanding of coding, insurance, and Federal, State, and 3rd party billing/reimbursement requirements. Experience with PC applications including MS Office and Internet. Ability to maintain employer training requirements.
Duties and Responsibilities:
- Uses integrated health information systems and telephone technology with customer service skills to facilitate customer interactions such that the customer experiences the Medical Center and its entities as an accessible, coordinated, and seamless entity.
- Obtains and enters accurate and complete patient registration data into EPIC. Confirms and corrects billing address, subscriber, insurance plan, coordination of benefit and missing information in EPIC. Assures accurate information is gathered to support clinical and financial needs including changes to insurance and other patient information.
- Performs an accurate search for patient in EPIC data base, thus, reducing the number of duplicate patient records. Assesses the patient’s financial ability to pay for services, referring patients to financial counseling staff when appropriate. Ensures all EPIC fields are completed with accurate information and sends EPIC messages for referral requests to all other internal providers.
- Provides required clinical, insurance, and demographic information to payer to obtain precertification and assume benefit reimbursement. Verifies eligibility and insurances via various tools. Requests and creates referrals for specified population, as required.
- Sends eligibility requests to all payers to complete accurate registration.
- Pre-certifies and obtains authorization numbers and enter into patient’s account obtaining medical, ICD and CPT codes.
- Submits documentation of referrals to insurance companies as identified.
- Contacts external companies to verify patient’s employment and insurance information for Workers compensation cases, as required.
- Provides accurate information to billing and case management to assure payment of claims.
- Interacts and maintains excellent working relationships with medical staff, referring physicians, and their designees to obtain complete, accurate, timely clinical and financial information required for payer reimbursement.
- Displays the highest level of customer service, attentiveness, and consideration possible in all cases, keeping within the standard set by the Office of Compliance and HIPAA in reference to confidentiality.
- Alerts management of problems.
- Other duties as assigned.
Interested candidates should e-mail their resume, cover letter, and salary requirements to email@example.com or click here to submit that information.