Pre-Registration/Insurance Verification Representative at OU Health

, Oklahoma, United States -

Full Time

Start Date

Immediate

Expiry Date

14 Feb, 26

Salary

0.0

Posted On

16 Nov, 25

Experience

0 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Communication, Customer Orientation, Interpersonal Skills, PC Skills, Policies & Procedures, Basic Skills

Industry

Hospitals and Health Care

Description

Position Title: Pre-Registration/Insurance Verification Representative Department: Admitting Job Description: General Description: Responsible for timely and accurate pre-registration and insurance verification. Accurately interprets managed care contracts. Essential Responsibilities: Performs pre-registration and insurance verification within 24 hours of receipt of reservation/notification for both inpatient and outpatient services Follows scripted benefits verification and pre-certification format in Meditech custom benefits screen and record benefits and pre-certification information therein Contacts physician to resolve issues regarding prior authorization or referral forms Assigns plans accurately Performs electronic eligibility confirmation when applicable and document results Researches Patient Visit History to ensure compliance with payor specific payment window rules Completes Medicare Secondary Payor Questionnaire as applicable for retention in Abstracting module Calculates patient cost share and be prepared to collect via phone or make payment arrangement Contacts patient via phone (with as much advance notice as possible, preferably 48 hours prior to date of service) to confirm or obtain missing demographic information, quote/collect patient cost share, and instruct patient on where to present at time of appointment Receives and records payments from patient for services scheduled. Utilizes appropriate communication system to facilitate communication with hospital gatekeeper Performs insurance verification and pre-certification follow up for prior day’s walk in admissions/registrations and account status changes by assigned facility Communicates with hospital based Case Manager as necessary to ensure prompt resolution of pre- existing, non-covered, and re-certification issues Utilizes Meditech account notes and Collections System account notes as appropriate to cut and paste benefit and pre-authorization information and to document key information Meets/exceeds performance expectations and completes work within the required time frames Implements and follows system downtime procedures when necessary Practices and adheres to the “Code of Conduct” philosophy and “Mission and Value Statement” General Responsibilities: Other duties as assigned Minimum Qualifications: Education: High school diploma or GED required Experience: 0-3 years experience; At least three years of insurance verification experience preferred License(s)/Certification(s)/Registration(s) Required: N/A Knowledge, Skills and Abilities: Communication - communicates clearly and concisely, verbally and in writing Customer orientation - establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations Interpersonal skills - able to work effectively with other employees, patients and external parties PC skills - demonstrates proficiency in PC applications as required Policies & Procedures - demonstrates knowledge and understanding of organizational policies, procedures and systems Basic skills - able to perform basic mathematical calculations, balance and reconcile figures, punctuate properly, spell correctly and transcribe accurately Current OU Health Employees - Please click HERE to login. OU Health is an equal opportunity employer. We offer a comprehensive benefits package, including PTO, 401(k), medical and dental plans, and many more. We know that a total benefits and compensation package, designed to meet your specific needs both inside and outside of the work environment, create peace of mind for you and your family. OU Health is the state’s only comprehensive academic health system of hospitals, clinics and centers of excellence. With 11,000 employees and more than 1,300 physicians and advanced practice providers, OU Health is home to Oklahoma’s largest doctor network with a complete range of specialty care. OU Health serves Oklahoma and the region with the state’s only freestanding children’s hospital, the only National Cancer Institute-Designated OU Health Stephenson Cancer Center, Oklahoma’s flagship hospital, which serves as the state’s only Level 1 trauma center and Edmond Medical Center in the heart of the Edmond Community. Becker’s Hospital Review named University of Oklahoma Medical Center one of the 100 Great Hospitals in America for 2020. OU Health’s oncology program at OU Health Stephenson Cancer Center was named Oklahoma’s top facility for cancer care by U.S. News & World Report in its 2020-21 rankings. OU Health also was ranked by U.S. News & World Report as high performing in these specialties: Colon Surgery, COPD and Congestive Heart Failure. OU Health’s mission is to lead healthcare in patient care, education and research. Experts in prevention, treatment and cures, our team works to improve lives through innovation in medical care, education and research, while investing in the people, technologies and facilities that will enable us to achieve our goals. We are seeking individuals who have a passion and talent for caring for others. By joining our team, you will provide quality health care to our community through the work you do every day. We provide clinical and non-clinical opportunities to further your career and we invite you to explore our available positions. Equal employment opportunities are provided to all employees and applicants for employment without regard to race, color, religion, gender, national origin, age, disability, sexual orientation, gender identity, genetic information or protected veteran status in accordance with applicable federal laws. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, placement, promotion, termination, layoff, transfer, leaves of absence, compensation, and training. Reasonable accommodations are made to the known physical and mental limitations of qualified individuals with disabilities.

Responsibilities

Responsible for timely and accurate pre-registration and insurance verification. Accurately interprets managed care contracts and performs necessary follow-ups.