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Employment Type:

Full time

Shift:

Day Shift

Description:

Position Purpose:

Saint Alphonsus Health System is hiring a PreService Specialist to support the Regional Scheduling Team. This position is responsible for scheduling patients for services within Saint Alphonsus Health System, performing insurance verification and prior authorizations, and notifying patients of their appointments prior to services being rendered.

Position Highlights and Benefits:

+ Schedule Information: This position will be scheduled for 40 hours a week from 9am to 5:30pm Monday through Friday.

+ Hybrid Eligibility: This role will be eligible for hybrid work after an initial training period as designated by the hiring manager.

+ Day 1 Benefits for colleagues! Our comprehensive benefit package includes medical, vision, dental, paid time off, 403B, education assistance and more.

Minimum Qualifications:

+ High school diploma or equivalent required.

+ Associate degree or an equivalent combination of education and experience preferred but not required. Data entry skills (50-60 keystrokes per minute).

+ Past work experience of at least 2 years within healthcare and/or payer environment performing patient access and/or customer service activities is highly desired but not required.

What You Will Do:

+ Responsible for pre-registering the patient for upcoming visit(s) by interviewing the patient, family member and/or guarantor.

+ Validates, obtains and enters demographic, clinical, financial, and insurance information into the patient accounting system.

+ Utilizes multiple modes of communication (phone, fax, patient portal/e-mail, mail, etc.) and in a professional, accurate, efficient and courteous manner to obtain information and ensure good patient relations and a smooth billing process.

+ During pre-registration calls, the position will provide information regarding directions, parking, transportation service, overnight accommodations, etc. Pre-Registration may be initiated by Scheduling staff with follow-up by the Pre-Service Specialist to ensure data integrity and completeness.

+ Performs insurance eligibility/benefit verification, utilizing a variety of mechanisms (primarily EDI transactions and payer web access, and in some cases by calling payers directly) and documenting information within the patient accounting system. Outcomes of the insurance eligibility/benefit verification activity will determine next steps (designation as a Self-Pay account, referral to financial counseling, etc.).

+ Determines need for appropriate service authorizations (pre-certifications, third-party authorizations, referrals) and will contact the physician and Case Management/Utilization Review personnel, as necessary.

+ Informs patient/guarantor of their liabilities and collects appropriate patient liabilities, including co-payments, co-insurances, deductibles, deposits and outstanding balances at the point of pre-registration. Calculates patient liabilities and provides financial education, referring the patient to financial counseling, as required. Documents payments/actions in the patient accounting system and provides the patient with a payment receipt in the collection of funds.

+ Validates medical necessity (LCD/NCD review) of Medicare and Non-Medicare cases to ensure clinical and financial clearance. Contacts scheduling and/or ancillary department staff for clarification, if cases require clarification of diagnosis and/or test(s)/procedure(s).

Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.

Our Commitment to Diversity and Inclusion

Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.

Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity.

EOE including disability/veteran