Pre Service Center Verification Specialist

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

📋 Description

• Facilitate financial clearance processes through pre-registration, insurance verification, referrals, prior authorizations, precertifications, and pre-service collections.

• Oversee registration, referral, and prior authorization work queues while clearing accounts.

• Navigate BMC and payer policies to secure approvals and enhance patient access.

• Provide assistance to BMC staff regarding financial clearance challenges.

• Acquire and record referrals and prior authorizations in Epic and practice management systems.

• Collaborate with practices, physicians, insurance carriers, patients, and departments to resolve clearance challenges.

• Follow up on management reports and work queues.

• Escalate denied or financially unresolved accounts in accordance with policy.

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

• Establish complete registration records for new patients at Boston Medical Center.

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

• Uphold confidentiality and adhere to healthcare collection laws and organizational policies.

• Engage in education, development, quality audits, and process improvement initiatives.

• Meet productivity and quality standards while managing telephone calls in line with customer service expectations.

⛳️ Requirements

• High School Diploma or GED is required; an associate's degree or higher is preferred.

• 1–3 years of experience in hospital registration and/or insurance is desirable.

• A minimum of one year in a customer service role.

• General understanding of healthcare terminology and CPT-ICD10 codes.

• Comprehensive knowledge of insurance is preferred.

• Proven customer service skills.

• Exceptional interpersonal skills.

• Strong written and verbal communication abilities.

• Capability to function in a complex environment with diverse perspectives.

• Comfort with ambiguity, sound judgment, and attention to detail.

• Familiarity with and experience using Epic is preferred.

• Technical proficiency in Epic work queues and ancillary systems, including ADT/Prelude/Grand Centrale.

• Ability to maintain strict confidentiality of personal and health-sensitive information.

• Skill in managing challenging situations and balancing multiple priorities.

• Basic computer skills, including proficiency in Microsoft Excel, Word, Outlook, and Zoom.

• Understanding of Revenue Cycle processes and ability to meet productivity benchmarks.

🏝️ Benefits

• Medical, dental, vision, and pharmacy benefits.

• Contract increases.

• Flexible Spending Accounts.

• 403(b) savings matches.

• Earned time cash out.

• Paid time off.

• Opportunities for career advancement.

• Resources to support employee and family wellbeing.

• Educational offerings and professional development opportunities.

• Remote work options.