Pre-Service Rep

Ochsner Health Opportunity

We've made a lot of progress since opening the doors in 1942, but one thing has never changed - our commitment to serve, heal, lead, educate, and innovate. We believe that every award earned, every record broken and every patient helped is because of the dedicated employees who fill our hallways.

At Ochsner, whether you work with patients every day or support those who do, you are making a difference and that matters. Come make a difference at Ochsner Health and discover your future today!

This job assumes responsibility for providing overall support to one of the following areas: Pre-Service, ED Registration, Financial Counseling, Call Center, Billing, Collections/Follow-Up, Self-Pay, Credentialing, Denials. Ensures the financial security of accounts for the organization's patients in various ways; assumes responsibility for working and advising patient of their financial responsibility whether it is a patients self pay, co-payment or deductible; ensures the financial security of company patient accounts by carrying out one of the following functions: verifying benefits, obtaining authorizations, billing or collecting, resolving denied claims, financial counseling, credentialing, or registering patients; and directly supports the business office by assisting with the reduction of bad debt. This job is customer service focused with demonstrated ability to gather and disseminate information through effective communication with various groups, either in person or over the phone; exercises good judgment in handling payment or billing related issues with the aptitude to solve problems effectively and efficiently; and assumes responsibility for increasing patient satisfaction by consistently representing the organization professionally.

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential duties. This job description is a summary of the primary duties and responsibilities of the job and position. It is not intended to be a comprehensive or all-inclusive listing of duties and responsibilities. Contents are subject to change at the company's discretion.

Education

Required - High School diploma or equivalent

Preferred - Associates degree or Bachelor Degree

Work Experience

Required - 1 year direct experience in hospital, clinic, business services/revenue cycle, front line registration, financial counseling, and/or customer service related job

Preferred - 4 years direct experience in hospital, clinic, business services/revenue cycle, front line registration, financial counseling, and/or direct experience in a healthcare environment

Knowledge Skills and Abilities (KSAs)

• Must have computer skills and dexterity required for data entry and retrieval of patient information.
• Effective verbal and written communication skills and the ability to present information clearly and professionally to varying levels of individuals throughout the patient care process.
• Must be proficient with Windows-style applications, keyboard, and various software packages specific to role.
• Strong interpersonal skills.
• Ability to multi-task.
• Ability to perform effectively in a fast paced ever changing environment.
• Ability to remain calm and professional in high pressure/stressful situations regarding patient financial and medical conversations.
• Reliable transportation to travel to other facilities to fill in as needed.

Job Duties

• Prepares, validates and completes all steps necessary to clear new cases for pre-scheduled services. This includes, but is not limited, to validating and gathering insurance and demographic information.
• Interacts with insurance companies via, website, phone, or fax to verify benefits, obtain authorizations, identify insurance guidelines, and facilitate communication.
• Gathers information to verify benefits and benefits eligibility by utilizing the EPIC system.
• Completes and obtains all necessary authorizations for the service(s) to be performed. Works with the clinical providers, on- site case management team, as well as LPN/RN or Nurse Auditor in the Pre-Service department.
• Performs Pre-Service collection estimation functions and communicates patient liability.
• Provides point of service information and logistics to ensure an exceptional patient experience.
• Other related duties as required.

The above statements describe the general nature and level of work only. They are not an exhaustive list of all required responsibilities, duties, and skills. Other duties may be added, or this description amended at any time.

Remains knowledgeable on current federal, state and local laws, accreditation standards or regulatory agency requirements that apply to the assigned area of responsibility and ensures compliance with all such laws, regulations and standards.

This employer maintains and complies with its Compliance & Privacy Program and Standards of Conduct, including the immediate reporting of any known or suspected unethical or questionable behaviors or conduct; patient/employee safety, patient privacy, and/or other compliance-related concerns. The employer is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or disability status.

Physical and Environmental Demands The physical demands described here are representative of those that must be met 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.

Sedentary Work - Exerting up to 10 pounds of force occasionally and/or a negligible amount of force frequently to lift, carry, push, pull, or otherwise move objects. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.

Normal routine involves no exposure to blood, body fluid or tissue and as part of their employment, incumbents are not called upon to perform or assist in emergency care or first aid.

The incumbent has no occupational risk for exposure to communicable diseases.

Because the incumbent works within a healthcare setting, there may be occupational risk for exposure to hazardous medications or hazardous waste within the environment through receipt, transport, storage, preparation, dispensing, administration, cleaning and/or disposal of contaminated waste. The risk level of exposure may increase depending on the essential job duties of the role.