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Pre-Registration/Insurance Verification Representative, 9:00A-5:30P

Company: Oklahoma University Medical Center
Location: Oklahoma City
Posted on: June 23, 2022

Job Description:

Position Title:Pre-Registration/Insurance Verification Representative, 9:00A-5:30P

Department:Admitting

Job Description:

General Description: Responsible for timely and accurate pre-registration and insurance verification. Accurately interprets managed care contracts.

Essential Responsibilities:

  • Performs pre-registration and insurance verification within 24 hours of receipt of reservation/notification for both inpatient and outpatient services
  • Follows scripted benefits verification and pre-certification format in Meditech custom benefits screen and record benefits and pre-certification information therein
  • Contacts physician to resolve issues regarding prior authorization or referral forms
  • Assigns plans accurately
  • Performs electronic eligibility confirmation when applicable and document results
  • Researches Patient Visit History to ensure compliance with payor specific payment window rules
  • Completes Medicare Secondary Payor Questionnaire as applicable for retention in Abstracting module
  • Calculates patient cost share and be prepared to collect via phone or make payment arrangement
  • Contacts patient via phone (with as much advance notice as possible, preferably 48 hours prior to date of service) to confirm or obtain missing demographic information, quote/collect patient cost share, and instruct patient on where to present at time of appointment
  • Receives and records payments from patient for services scheduled.
  • Utilizes appropriate communication system to facilitate communication with hospital gatekeeper
  • Performs insurance verification and pre-certification follow up for prior days walk in admissions/registrations and account status changes by assigned facility
  • Communicates with hospital based Case Manager as necessary to ensure prompt resolution of pre- existing, non-covered, and re-certification issues
  • Utilizes Meditech account notes and Collections System account notes as appropriate to cut and paste benefit and pre-authorization information and to document key information
  • Meets/exceeds performance expectations and completes work within the required time frames
  • Implements and follows system downtime procedures when necessary
  • Practices and adheres to the Code of Conduct philosophy and Mission and Value Statement

    General Responsibilities:

    • Other duties as assigned

      Minimum Qualifications:

      Education: High school diploma or GED required

      Experience: At least three years of insurance verification experience preferred

      License(s)/Certification(s)/Registration(s) Required: N/A

      Knowledge, Skills and Abilities:

      • Communication - communicates clearly and concisely, verbally and in writing
      • Customer orientation - establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations
      • Interpersonal skills - able to work effectively with other employees, patients and external parties
      • PC skills - demonstrates proficiency in PC applications as required
      • Policies & Procedures - demonstrates knowledge and understanding of organizational policies, procedures and systems
      • Basic skills - able to perform basic mathematical calculations, balance and reconcile figures, punctuate properly, spell correctly and transcribe accurately

        Current OU Health Employees - Please click to login. OU Health is an equal opportunity employer. We offer a comprehensive benefits package, including PTO, 401(k), medical and dental plans, and many more. We know that a total benefits and compensation package, designed to meet your specific needs both inside and outside of the work environment, create peace of mind for you and your family.

Keywords: Oklahoma University Medical Center, Oklahoma City , Pre-Registration/Insurance Verification Representative, 9:00A-5:30P, Other , Oklahoma City, Oklahoma

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