Job Description

Per Diem Pre Services Specialist - Radiation Oncology - Coverage needs possible both at the Manchester and Londonderry locations. Weekday coverage needs.

About the Job

To provide superior service excellence and promote the Elliot Experience to all who access the Elliot Health System. Pre-Services Specialists are dedicated to completing patient access workflows related to scheduled patient services for the inpatient, ambulatory, and physician practice settings. Pre-Services Specialists work directly with referring physician offices, payers, and patients to ensure full financial clearance prior to the provision of care.

What You'll Do

• Establishes contact with patients via inbound and outbound calls and accesses department Pre Registration work queues to pre-register patients for future dates of service.
• Verifies insurance eligibility and benefits by utilizing integrated real-time eligibility tool, payer websites, and telephone calls to payers documents, payer verification responses in designated fields within the registration pathway.
• Compares the primary care physician (PCP) information indicated by the insurance verification response to the location of the primary care office visit, if applicable; contacts the patient and provides guidance for resolution of PCP discrepancies or mismatches.
• Validates insurance referral status, if applicable, and communicates with PCP office to obtain referrals.
• Validates pre-certification status, if applicable, and communicates with ordering physicians’ offices to obtain pre-certification information, documents pre-certification status in designated field within the registration pathway.
• Provides notification of admission to payers within 24 hours of admission for inpatient stays.
• Initiates and completes the Medicare Secondary Payer Questionnaire (MSPQ) via a phone interview with the patient as necessary.
• Interprets insurance verification information to estimate patient financial responsibility amounts for scheduled services and inpatient stays.
• Communicates patient financial responsibility amounts and initiates the point of service (POS) collections process.
• If a patient Identifies or is identified as requiring payment assistance options the PSS would contact social work to help facilitate communication between patients and EHS Financial Counselors.
• Works collaboratively with all departments/services of the Elliot Health System to ensure that all scheduled patients have undergone financial clearance prior to service.
• Receives and directs incoming calls for inpatient and outpatient services.
• Schedules and coordinates physician, patient, department and hospital resources to assure prompt patient services.
• Keeps informed of department needs and coordinates schedules to meet test and procedure requirements.
• Provides pre-test instructions to patients for selected tests/procedures to ensure that patients are appropriately prepared for testing.
• Promotes utilization of off-site facilities by educating patients as to services provided and location.

What You'll Need

High school diploma or equivalent required. Experience in healthcare Patient Access registration or insurance verification or office/customer service experience preferred.

Work Schedule: Days