Pre-Service Center Verification Specialist

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

📋 Description

• Oversee financial clearance processes including pre-registration, patient demographic and insurance validation, insurance verification, referral authorization, precertification, and pre-service cash collections.

• Track registration, referral, and prior authorization work queues to gather the necessary financial clearance components.

• Navigate BMC and payer policies to obtain approvals, authorizations, precertifications, and referrals.

• Assist BMC staff with any financial clearance challenges.

• Acquire insurance verification, authorizations, and referrals through online databases, electronic communication, faxes, and phone calls.

• Record referrals and prior authorizations in Epic and practice management systems.

• Work collaboratively with practices, physicians, insurance carriers, patients, and departments to resolve issues related to registration, insurance, referrals, and authorizations.

• Follow up on management reports and work queues, escalating denied or uncleared accounts as necessary.

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

• Create registration records for new patients and update demographic and insurance information.

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

• Ensure confidentiality and inform management of any compliance concerns.

• Engage in education, process improvement, quality audits, and revenue cycle collaboration.

• Meet productivity and quality expectations while managing telephone communications according to customer service standards.

⛳️ Requirements

• A High School Diploma or GED is a must.

• 1-3 years of experience in Hospital registration and/or Insurance is preferred.

• At least one year of experience in a customer service position is required.

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

• Knowledge of insurance processes.

• Proven customer service abilities.

• Outstanding interpersonal skills.

• Strong written and verbal communication skills.

• Capable of making decisions, exercising judgment, and paying attention to detail.

• Experience with Epic is preferred.

• Technical proficiency with Epic workqueues and ancillary systems, including ADT/Prelude/Grand Centrale.

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

• Ability to manage challenging situations and juggle multiple priorities effectively.

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

• Understanding of Revenue Cycle processes is advantageous.

• Adherence to healthcare collection regulations and confidentiality policies is essential.

🏝️ 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.

• Career advancement opportunities.

• Resources available to support employee and family wellbeing.

• Educational offerings and various development opportunities.

• Fully remote work arrangement.

• No requirement to purchase equipment prior to or for employment.