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Pre-Services Coordinator (Prior Authorization/Pre-Registration) in Indianapolis, IN at Eskenazi Health

Date Posted: 5/19/2019

Job Snapshot

  • Employee Type:
    Full-Time
  • Job Type:
  • Experience:
    At least 2 year(s)
  • Date Posted:
    5/19/2019

Job Description

Organization: HHC

Eskenazi Health serves as the public hospital division of the Health & Hospital Corporation of Marion County. Physicians provide a comprehensive range of primary and specialty care services at the 315-bed hospital and outpatient facilities both on and off of the Eskenazi Health downtown campus as well as at 10 Eskenazi Health Center sites located throughout Indianapolis.

JOB SUMMARY:

The Pre-Services Coordinator works directly with patients, referring physician offices, and payers, to ensure full payer clearance prior to receiving care, through pre-registration, financial clearance, authorization, referral validation, and pre-serviceability estimations and collections. The Pre-Services Coordinator establishes the first impression of Eskenazi Health for patients, families, and other external/internal customers, serving as a subject matter expert as it relates to payer requirements, authorizations, appeals and patient navigation.

ESSENTIAL JOB FUNCTIONS:

Verifies insurance information through payer contacts via telephone, online resources, or electronic verification systems and identifies payer authorization/referral requirements. Conducts pre-registration functions, validates patient demographic data, identifies and verifies medical benefits, accurate plan codes and Coordination of Benefits orders.

  • Corrects and updates all necessary data to assure timely, accurate bill submission
  • Maintains accountability for accuracy of data collected and entered into systems and demonstrates the ability to maintain the passing grade on monthly. audits                                                                                          
  • Provides appropriate documentation and follow up to patients, physician offices, case management departments, and payers regarding authorization/referral deficiencies
  • Contacts insurance carriers or other sources to obtain prior authorizations; obtains pre-certification and/or authorization prior to services  
  • Identifies all patient financial responsibilities, calculates estimates, collects liabilities, posts payment transactions, and completes waivers as appropriate in the Epic system
  • Identifies self-pay and complex liability calculations and escalates account to Financial Counselors as appropriate
  • Delivers positive patient experience using AIDET
  • Counsels patients regarding insurance benefits by explaining financial responsibilities for services received, payment options, and collections procedures to patients and parties responsible for payment
  • Performs any written and verbal communication necessary to exchange information with designated contacts and promote working relationships with patients, Eskenazi Health leadership and staff, physician offices, and external/internal customers
  • Initiates process for collecting prepays due and performs follow-up to insure maximum collection is achieved
  • Updates and correctly documents in Epic
  • Attains productivity standards, recommending new approaches for enhancing performance and productivity when appropriate
  • Attains quality standards, recommending new approaches for enhancing quality when appropriate

JOB REQUIREMENTS:

High School Diploma or GED required; Accredited Bachelor's degree preferred or 2 years of experience in a Pre-Services setting in lieu of Bachelor's degree

Certification in Healthcare Business Insights within 60 days of hire

Accredited by The Joint Commission and named one of the nation’s 150 best places to work by Becker’s Hospital Review for three consecutive years and Forbes list of best places to work for women, and Forbes list of America’s best midsize employers’ Eskenazi Health’s programs have received national recognition while also offering new health care opportunities to the local community. As the sponsoring hospital for Indianapolis Emergency Medical Services, the city’s primary EMS provider, Eskenazi Health is also home to the first adult Level I trauma center in Indiana, the only verified adult burn center in Indiana, the first community mental health center in Indiana and the Eskenazi Health Center Primary Care – Center of Excellence in Women’s Health, just to name a few.