Pre Services Representative - Concord Hospital Laconia | Full Time | Days

Insurance Verification Pre Services Representative

This position performs insurance verification for provider offices and outpatient services, utilizing Phreesia and Rev Cycle. Verifying insurance benefits through Insurance websites and troubleshooting Insurance eligibility errors.

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.

Full time 40 hours/week Monday through Friday 7:30 am - 4:00 pm

High school diploma or equivalent (GED).

Responsibilities

• Performs insurance authorization for elective outpatient radiology imaging and cardiovascular testing.
• Schedules, reschedules and cancels appointments and enters data into Schapptbook according to program logic and Scheduling Guidelines.
• Handles phone calls in a professional and efficient manner adhering to department call standards 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 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.

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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 View phone number on click.appcast.io.

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.