This site uses cookies. To find out more, see our Cookies Policy

Pre-Services Coordinator in Indianapolis, IN at Eskenazi Health

Date Posted: 1/10/2019

Job Snapshot

  • Employee Type:
    Full-Time
  • Job Type:
  • Experience:
    Not Specified
  • Date Posted:
    1/10/2019

Job Description

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