Physician Billing, Insurance & Pre-Registration Rep, FT, Days, - Remote
通过在线资格，网站或电话查询保险管理员和/或第三方付款人并确保保险列出准确且完整。根据部门指南要求启动，获得和文件预认证/事先授权。基本功能 · 所有团队成员都应该了解并遵守普里斯玛健康的目的：激励健康。用同情服务。做不同。· 通过在线资格，网站或电话查询保险管理员和/或第三方付款人来验证保险覆盖性/福利。通过保险验证获得的信息必须始终在 EPIC 患者收费系统中准确且完整地记录下来。确保根据第三方要求/COB 确定保险优先事项。· 使用保险资格和福利答案识别当前患者责任。根据部门指南所需的文件，以帮助确保服务时 correct patient payments are collected. ·根据部门指南要求，发起，获得和记录预认证/事先授权。· 向适当人员传达新的保险系统问题，以便进行审查/纠正。在部指导方针下手动修改/更新目前已确定的保险问题，直到可以实施纠正。· 履行其他任务。监督/管理责任。· 这是一项非管理工作，将报告给一名监管人，经理，董事或执行官。最小要求 · 教育 - 高中文凭或相当于高中文凭/学历。·经验 - 两个 (2) 年的账户，会计或会计经验而不是 NA 所需的证书，注册和许可证 ·NA 知识，技能和能力 ·保持有关当前保险的最新知识，包括但不限于计划运行系统，适当的方式来纠正系统中的错误以及对未通过该系统运行的保险的资格和福利进行正确核实。·保持当前管理护理合同的最新知识并利用正确的网络或离线状态。
查看英文原文
Inspire health. Serve with compassion. Be the difference.
Job Summary
Verifies insurance coverage/benefits and current patient responsibility utilizing online eligibility, websites or telephone inquiry to the insurance administrator and/or third-party payor and ensures insurance is listed accurately and completely. Initiates, obtains, and documents pre-certification/prior authorizations as required according to Departmental Guidelines.Essential Functions
- All team members are expected to be knowledgeable and compliant with Prisma Health's purpose: Inspire health. Serve with compassion. Be the difference.
- Verifies insurance coverage/benefits utilizing online eligibility, websites or by telephone inquiry to the insurance administrator and/or third-party payor. Information obtained through insurance verification must always be documented accurately and completely in the EPIC patient billing system. Ensures insurance priorities are correct based on third-party requirements/COB.
- Identifies current patient responsibility using insurance eligibility and benefit responses. Documents patient responsibility as required according to Departmental Guidelines to help ensure correct patient payments are collected at time of service.
- Initiates, obtains, and documents pre-certifications /prior authorizations as required according to Departmental Guidelines.
- Communicates new insurance system issues to appropriate personnel to be reviewed/corrected. Manually corrects/updates current identified insurance issues according to departmental guidelines until correction can be implemented.
- Performs other duties as assigned.
Supervisory/Management Responsibilities
· This is a non-management job that will report to a supervisor, manager, director or executive.
Minimum Requirements
- Education - High School diploma or equivalent OR post-high school diploma/highest degree earned
- Experience - Two (2) years billing, bookkeeping, or accounting experience
In Lieu Of
· NA
Required Certifications, Registrations, Licenses
· NA
Knowledge, Skills and Abilities
- Maintains up-to-date knowledge regarding current insurances including but not limited to which plans run through system, appropriate ways to fix errors in the system, and appropriate manners of correctly verifying eligibility and benefits for insurances that do not run through the system.
- Maintains up-to-date knowledge of current managed care contracts and utilizes correct network or out-of-network status for each insurance.
Work Shift
Day (United States of America)Location
Independence PointeFacility
CorporateDepartment
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Originally posted on Himalayas