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Employee Type:

Regular

Work Shift:

Day - 8 hour shift (United States of America)

Join Team Tidelands and help people live better lives through better health!

Pre-Services Representative II

Are you passionate about quality and committed to excellence? Consider joining our Tidelands Health team. As our region's largest health care provider, we are also one of our area's largest employers. More than 2,500 team members at more than 70 Tidelands Health locations bring our healing mission to life each day.

A Brief Overview

The purpose of this position is to obtain prior authorizations or provide financial clearance for patients of Tidelands Health. This role is key to securing reimbursement and minimizing organizational write offs. The Pre-Services Representative must consistently demonstrate skilled communication and troubleshooting techniques as well as excellent customer service skills. This position will have the ability to anticipate and respond to a wide variety of issues/concerns, and the ability to execute tasks efficiently and effectively. The position requires the ability to independently plan, schedule and organize numerous tasks as this position directly impacts hospital and physician reimbursement.

The Pre-Services Representative II is responsible for accurate and complete insurance verification, financial clearance and prior authorization, and complete pre-registration of all scheduled moderately complex procedures, while utilizing excellent customer services standards.

Education Qualifications

+ High School Diploma or equivalent Required

Experience Qualifications

+ At least two (2) years of experience in Healthcare Revenue Cycle that includes prior authorization.

Skills and Abilities

+ Ability to interact successfully with the public. Ability to perform effectively despite sudden deadlines and changing priorities; maintaining personal composure in high stress situations require

+ Ability to demonstrate a high level of interpersonal skills required to interact with patients, patients’ families/visitors and clinical staff required

+ Ability to perform with a high degree of accuracy and with meticulous attention to detail. Demonstrate a strong ability to use initiative and judgment and to identify, analyze and solve problems required

+ Knowledge of CPT and ICD coding preferred.

+ Knowledge of Medicare and third-party payer regulations and guidelines highly desired

Physical Demand

Light Physical Demand

The intent of this job description is to provide a representative and level of the types of duties and responsibilities that will be required of positions given this title and shall not be construed as a contract for employment nor a declaration of the total of the specific duties and responsibilities of any particular position. Employees may be directed to perform tasks other than those specifically presented in this description.

Tidelands Health is an Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, or veteran status.

Tidelands Health is an equal opportunity employer (EOE). Tidelands Health does not discriminate against employees or applicants for employment on the basis of race, color, creed, religion, age, national origin, disability, marital status, veteran status, gender, genetic information, familial status, or any other legally protected status.