Preregistration Specialist II

Description

Department: Financial Clearance

Location: Penn Medicine Bala Cynwyd- 2 Bala Plaza

Hours: Fulltime, Monday-Friday, 100% Remote 

Summary: The Pre-Registration Specialist II reports to the Supervisor of Financial Clearance, this individual possesses a more specialized knowledge of insurance plans and policies in regards to help resolve complex patient accounts and inquiries. The PreRegistration Specialist II ensures all financial obligations are communicated to patients clearly, are updated on the account, and are detailed to ensure expeditious processing of patient accounts in advanced practice based settings and outpatient hospital departments. This position reviews and works the unauthorized report to track and determine which accounts still need authorizations to be obtained. Accurately identifies primary and secondary payers. This individual will relay relevant financial information (e.g., price estimates and payment plan options) in a clear and patient-friendly manner. This position works collaboratively with scheduling, financial counseling, and registration staff members to ensure patient wait times are minimized on the day of service. This individual participates and assists with training and mentoring staff members according to the organization's training programs.

Accountabilities:

• Obtains and documents specific details related to financial clearing patients in advance of service. Financial Clearance includes demographic, insurance, referrals, authorizations/pre-certification (if necessary).
• Certifies patient demographic, insurance, and financial data collected during scheduling and pre-registration activities.
• Appropriately collects and/or sets payment arrangements with patients or their representative, scheduling payments on deposits due, which may include screening of patients for enrollment in available credit option programs.
• Effectively communicates with payer to determine extent of coverage and other limitations or co-payments provisions.
• Maintains knowledge of and complicates with each payer’s requirements for verifying insurance and obtaining preauthorization’s/pre-certifications.
• Documents all information obtained during pre-registration activities. Identifies un-and underinsured and low-income patients; refers them to financial staff who can help with financial assistance options and other arrangements prior to patient visit.
• Performs duties in accordance with Penn Medicine and entity values, policies, and procedures.
• Other duties as assigned to support the unit, department, entity, and health system organization.

Education and Experience:

• High School Diploma/GED (required)
• 5+ years work experience in Patient Access or Medical Billing (required)

Skills and Abilities:

• Experience in pre certification requirements, CMS medical necessity requirements, and third party billing processing
• Familiarity with federal regulations and other guidelines for patient registration and collections
• Excellent customer service skills (preferred)
• Negotiation and problem solving skills (preferred)
• Knowledge of medical terminology
• Ability to prioritize and handle multiple tasks (preferred)
• Ability to communicate clearly both verbally and in writing (preferred)
• Ability to work productively as part of a team (preferred)

We are an Equal Opportunity employer. Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran or any other status protected by applicable law.

High school diploma/GED required; 5+ years experience in patient access or medical billing; knowledge of pre-certification, CMS medical necessity, and third-party billing; excellent customer service and communication skills.

Key Responsibilities

• obtaining financial clearance
• verifying insurance
• documenting patient data

Job Details

• Category: Healthcare Services - Allied Health
• Seniority: Mid Level
• Commitment: Full Time
• Workplace: Remote — Bala Cynwyd, Pennsylvania, United States
• Languages: English

Benefits

• Tuition reimbursement

About Penn Medicine

A leading academic medical center dedicated to patient care, research, and education. — Industry: Healthcare