Pre Service Specialist 1

Nuvance Health has a network of convenient hospital and outpatient locations — Danbury Hospital, New Milford Hospital, Norwalk Hospital and Sharon Hospital in Connecticut, and Northern Dutchess Hospital, Putnam Hospital Center and Vassar Brothers Medical Center in New York — plus multiple primary and specialty care physician practices locations.

Summary:
Facilitates patient flow through the referral, scheduling, and financial clearance process.

Responsible for obtaining demographic and financial information to ensure accurate patient identification and to secure reimbursement.

Performs pre-registration functions and insurance eligibility verification.

Provides estimates for services.

Requests and secures payments

 

Responsibilities:


* May be assigned to schedule patients for hospital or medical group services by incoming phone calls, online requests, or outbound to patients.


* Work within the central referral management system to identify and schedule specialist and primary care referrals.


* Provides excellent customer service both to physician offices and patients.


* Performs insurance eligibility verification and executes payer requirements as needed.


* Obtains accurate insurance benefit information from payers, such as deductible, copay, and coinsurance amounts.


* Utilizes patient estimation tool to calculate estimate of patient liabilities.


* Initiates requests for authorizations, pre-certifications, notices of admission, and referrals from insurance companies.


* Follows up with payers and providers to ensure that authorizations are in place.


* Collects on such liabilities prior to time of service utilizing provided scripting.


* Refers patients who express financial hardship to Financial Counseling for a financial assessment.

Requirements:


* HS Diploma


* Required Minimum of 2-year job-related experience


* Associates Degree Preferred with 6 months job-related experience 


* National Association of Healthcare Access Management (NAHAM) certification within one year of hire

Location: Summit-100 Reserve Rd

Work Type: Full-Time

Standard Hours: 40.00

Work Shift: Variable hours Mon-Fri 8am - 8pm

Department: Corporate Financial Clearance

Salary Range: $15.30 - $28.22 Hourly (based upon experience)