Friday-Sunday 7:00am-7 :30pm WEO Shift differential

Occupat ionalSummary

• Accurately complete patient accounts based on departmental protocol, pol icies and procedures, and compliancewith regulatory agencies, to inc lude but not limited to pre-admission, pre-registration and d-registration functions.
• Ensure all insuran ce requirements are met prior to patients' arrival and inform patien ts of their financial liability prior to arrival for services.
• Arrange payment optionswith the patients and screens pati ents for government funding sources.
   
  Work Perfor med

• Analyze insurance coverage and be nefits for service to ensure timely.
• Obtain authorization-based payments based . on insurance plan contracts and guidelines.< /span>
• Documentbilling system.
• Expl ain bills provides assistanceto visitors and patients.
• < li>Explain policies anddepartmental coverage as requested.
• Calculate and according to PRMO credit and collection poli cies.
• Implement appropriate collect cash payme nts appropriately forall patients.
• Reconcile the daily necessity of third-party partysponsorship and process patients in accordance ordance reimbursement.
• Obtain all Prior authorization certifications and/or authorizations as appropriate.
• < li>Facilitate payment sources for uninsured patients.
• Determine if the patient's condition is the result of an accide nt and perform completeresearch to determine the appropriate source of l iability/payment.
• Admit, register and pre-regis ter patients withaccurate patient demographic and financial data.
• Resolve insurance claim rejections/denials and remedy expediently. 
• Evaluate diagnoses to ensure complianc e with the Local Mcessary toensure all accounts are processed accurately andefficiently.
• Perform those duties.
• Compile departmentalstatistics for budgetaryand reporting purpose.
• collection actions andassist financially re sponsible persons inarranging payment.
• Makeref erral for financialcounseling.
• Determine with p olicy and procedure.
• Examine insurance policie s and other third-party sponsorship materials forsources of payment.< /span>
• Inform the attending physician of the patient's financial hard ship.
• Complete the managed care waiver form fo r patients considered outof network and receiving services at a redu ced benefit level.
• Update the billing system t o reflect the insurance status of the patient.
• Ref er patients to theManufacturer manufacturer's drug program as needed for medication.
• Greets and procedures and resolves problems .
• Gathers necessarydocumentation to support the processing of inquiriesand complaints.
• Assis t with according topolicy and procedure.
• Enter and update referrals as required.
• Communicate with insurance carriersregarding regarding clinical information requested and to resolve issues relating to coverage
   
  Knowledge, Skills, and Abilities
•  

• Ex cellent communication skills, oral and written.
• Ability toanalyze relationships with patients, physicians, co-workers and supervisors. data, perform multiple tasks and work independently .
• Must be able to develop and maintain professional, service-oriented working, 
• Must be able to und erstand and comply with policies and procedures.
   
  Level Ch aracteristics

• Position responsible for high production generated accuratelyin accordance with established business processes or regulations.

Requires working knowledge of compliance principles. Job allows the opportunity to work independently.