Patient Registration and Authorization Specialist
2 weeks ago
Patient Registration and Authorization Specialist
Location:
Southlake Campus
Position Overview:
The Patient Registration and Authorization Specialist plays a crucial role in the healthcare process by identifying patients eligible for pre-registration, encompassing both new and returning patients. This position is responsible for collecting accurate demographic and insurance details, ensuring that all information is meticulously entered into the registration system. The Specialist also manages pre-service collections and documentation as necessary. This role encompasses the verification and pre-certification processes, including notification and authorization for all admissions and outpatient visits. For sponsored admissions, the Specialist will liaise with patients' employers and/or insurance providers to confirm coverage and benefits, ascertain benefit levels, patient liabilities, and billing addresses.
Key Responsibilities:
- Review daily reports to identify un-contacted patients prior to service, utilizing worklists for effective pre-registration and pre-certification of hospital services.
- Conduct telephone interviews with patients to gather essential demographic and third-party payer information required for billing.
- Input patient data directly into registration systems, ensuring completion of the Medicare Secondary Payer Questionnaire (MSPQ) when applicable.
- Verify eligibility with third-party payers, including checking certificate and group numbers, co-payment and deductible amounts, and statement mailing addresses, while adhering to Medicare, Medicaid, and other insurance regulations.
- Collaborate closely with clinics, hospital ancillary departments, and patient financial advisors to address potential insurance coverage complications.
- Secure accounts following established departmental policies, which may involve contacting patients, responsible payers, and referring uninsured or underinsured accounts to Financial Advisors.
- Maintain the ability to perform the professional, clinical, and technical competencies required for the assigned unit or department.
- These statements outline the essential functions of the role and are not intended to be an exhaustive list of all responsibilities; additional duties may be assigned as necessary.
- High School Diploma or GED.
- At least one year of experience with Epic systems.
- One or more years of experience in pre-registration or prior authorization processes.
Full-time
Equal Opportunity Employer:
We are committed to equal employment opportunities for all individuals, regardless of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, ancestry, age (40 or older), disability, veteran status, or genetic information.
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