Pre Service Center Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Oversee financial clearance processes including pre-registration, demographic and insurance validation, insurance verification, referrals, authorizations, precertifications, and pre-service cash collections.

• Supervise and clear registration, referral, and prior authorization work queues.

• Navigate BMC and payer policies to secure approvals for scheduled care.

• Assist BMC staff in comprehending and resolving financial clearance challenges.

• Collect and document referral and prior authorization details in Epic and practice management systems.

• Collaborate with practices, physicians, insurance providers, patients, case management, Patient Financial Counseling, and other departments.

• Follow up on management reports and work queues.

• Address registration, insurance verification, referral, and authorization issues; escalate denied or uncleared accounts.

• Conduct interviews with patients, families, and referring physicians to gather financial, demographic, insurance, and reimbursement information.

• Create comprehensive registration records for new patients at Boston Medical Center.

• Validate eligibility, primary care physician, subscriber, employer, and appointment information.

• Process copayments, coinsurance, deductibles, and outstanding balances from patients.

• Ensure confidentiality and adhere to HIPAA regulations, healthcare collection laws, infection control, safety, and organizational policies.

• Engage in training, quality audits, continuous improvement efforts, and educational opportunities.

• Meet standards for productivity, quality, customer service, and telephone handling.

• Report any faulty systems or hardware to the BMC Help Desk and maintain a safe, efficient workspace.

• Perform additional duties as assigned.

⛳️ Requirements

• High School diploma or equivalent is required.

• Minimum of one year of experience in registration.

• Advanced understanding of insurance payers and their requirements.

• Strong customer service abilities, sound judgment, independent thinking, creativity, and problem-solving skills.

• Solid grasp of healthcare insurance, related terminology, and CPT/ICD-10 codes.

• Excellent verbal and written communication skills in English.

• Exceptional interpersonal skills, professionalism, empathy, and the ability to build relationships.

• Capability to work independently, manage ambiguity, take initiative, and prioritize competing tasks.

• High attention to detail and strong decision-making skills.

• Experience with Epic is preferred, particularly proficiency in Epic workqueues.

• Strong knowledge of Revenue Cycle processes and the ability to meet productivity and performance benchmarks.

• Advanced computer skills, including proficiency in Microsoft Office (Excel, Word, Outlook, Teams) and data entry/interpretation.

• Ability to work collaboratively across various functions and provide backup coverage.

• Capacity to manage challenging situations while strictly maintaining the confidentiality of personal and health information.

• Additional professional certifications or completion of Revenue Partners training programs is preferred.

• Completion of SDK class training is highly preferred.

🏝️ Benefits

• Medical, dental, vision, and pharmacy benefits.

• Opportunities for contract increases.

• Flexible Spending Accounts.

• 403(b) savings matches.

• Earned time cash out options.

• Paid time off.

• Opportunities for career advancement.

• Resources available to support employee and family wellbeing.

• Option for remote work.