PB - Ins & Pre-Registration Rep, BMPG Cardiology, Blount, Full-Time, Days at Prisma Health

, Tennessee, United States -

Full Time

Start Date

Immediate

Expiry Date

21 Mar, 26

Salary

0.0

Posted On

21 Dec, 25

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Insurance Verification, Patient Responsibility, Pre-Certification, Prior Authorization, Documentation, Communication, Problem Solving, Knowledge of Insurance Plans, Managed Care Contracts, EPIC Patient Billing System

Industry

Hospitals and Health Care

Description

Inspire health. Serve with compassion. Be the difference. Job Summary Verifies insurance coverage/benefits and current patient responsibility utilizing online eligibility, websites or telephone inquiry to the insurance administrator and/or third-party payor and ensures insurance is listed accurately and completely. Initiates, obtains, and documents pre-certification/prior authorizations as required according to Departmental Guidelines. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's purpose: Inspire health. Serve with compassion. Be the difference. Verifies insurance coverage/benefits utilizing online eligibility, websites or by telephone inquiry to the insurance administrator and/or third-party payor. Information obtained through insurance verification must always be documented accurately and completely in the EPIC patient billing system. Ensures insurance priorities are correct based on third-party requirements/COB. Identifies current patient responsibility using insurance eligibility and benefit responses. Documents patient responsibility as required according to Departmental Guidelines to help ensure correct patient payments are collected at time of service. Initiates, obtains, and documents pre-certifications /prior authorizations as required according to Departmental Guidelines. Communicates new insurance system issues to appropriate personnel to be reviewed/corrected. Manually corrects/updates current identified insurance issues according to departmental guidelines until correction can be implemented. Performs other duties as assigned. Supervisory/Management Responsibilities This is a non-management job that will report to a supervisor, manager, director or executive. Minimum Requirements Education - High School diploma or equivalent OR post-high school diploma/highest degree earned Experience - Two (2) years billing, bookkeeping, or accounting experience In Lieu Of NA Required Certifications, Registrations, Licenses NA Knowledge, Skills and Abilities Maintains up-to-date knowledge regarding current insurances including but not limited to which plans run through system, appropriate ways to fix errors in the system, and appropriate manners of correctly verifying eligibility and benefits for insurances that do not run through the system. Maintains up-to-date knowledge of current managed care contracts and utilizes correct network or out-of-network status for each insurance. Work Shift Day (United States of America) Location Blount Memorial Hospital Facility 8104 BH POB Maryville Department 81041005 BMPG Cardiology Maryville Share your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.

Responsibilities

The role involves verifying insurance coverage and patient responsibilities, ensuring accurate documentation in the EPIC system, and initiating pre-certifications as required. Additionally, the representative communicates issues with the insurance system and performs other assigned duties.