Pre-Service Specialist

Elliot Pain Management and Interventional Spine Center

The Elliot Pain Management and Interventional Spine Center at River's Edge is a multi-disciplinary group of professionals committed to the compassionate treatment of patients in pain. The Center specializes in the scientific assessment, diagnosis, and treatment of pain-related disorders. We believe that early diagnosis and minimally invasive interventional therapy substantially reduces the number of patients requiring surgery or proceeding toward disability.

Monday-Friday, 7:30am-4:00pm, 32 hours weekly

Pre-Services Specialists are dedicated to completing patient access workflows related to scheduled patient services for the inpatient, ambulatory, and physician practice settings. Pre-Services Specialists work directly with referring physician offices, payers, and patients to ensure full financial clearance prior to the provision of care.

Key Responsibilities

• Follows established department policies to completely and accurately pre-register patients, verify insurance eligibility and benefits, validate pre-certification or referral status, and collect patient responsibility amounts for services provided throughout the EHS enterprise.
• Establishes contact with patients via inbound and outbound calls and accesses department Preregistration work queues to pre-register patients for future dates of service.
• Verifies insurance eligibility and benefits by utilizing integrated real-time eligibility tools, payer websites, and telephone calls to payers documents, payer verification responses in designated fields within the registration pathway.
• Compares the primary care physician (PCP) information indicated by the insurance verification response to the location of the primary care office visit, if applicable; contacts the patient and provides guidance for resolution of PCP discrepancies or mismatches.
• Validates insurance referral status, if applicable, and communicates with PCP office to obtain referrals.
• Validates pre-certification status, if applicable, and communicates with ordering physicians offices to obtain pre-certification information, documents pre-certification status in designated field within the registration pathway.
• Provides notification of admission to payers within 24 hours of admission for inpatient stays.
• Initiates and completes the Medicare Secondary Payer Questionnaire (MSPQ) via a phone interview with the patient as necessary.
• Interprets insurance verification information to estimate patient financial responsibility amounts for scheduled services and inpatient stays.
• Communicates patient financial responsibility amounts and initiates the point of service (POS) collections process.
• Identifies patients requiring payment assistance options and facilitates communication between patients and EHS Financial Counselors.
• Works collaboratively with all departments/services of the Elliot Health System to ensure that all scheduled patients have undergone financial clearance prior to service.
• Receives and directs incoming calls for inpatient and outpatient services.
• Schedules and coordinates physician, patient, department, and hospital resources to assure prompt patient services.
• Keeps informed of department needs and coordinates schedules to meet test and procedure requirements.
• Provides pre-test instructions to patients for selected tests/procedures to ensure that patients are appropriately prepared for testing.
• Promotes utilization of off-site facilities by educating patients as to services provided and location.

Education/Experience/Licensure

• High school diploma or equivalent required.
• A minimum of two years of healthcare experience in Patient Access registration, preregistration, or insurance verification or equivalent office / customer service experience required.

What Elliot Health System Has to Offer

• Health, dental, prescription, and vision coverage for full-time & part-time employees
• Short-term disability, long-term disability, and life insurance coverage
• Competitive pay
• Tuition Reimbursement
• 403(b) Retirement Savings Plan