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POSITION SUMMARY:

Facilitates the conversion of referrals to admissions through the completion of the intake process and the use of effective phone and customer service skills.

ESSENTIAL JOB FUNCTIONS, DUTIES, AND RESPONSIBILITIES:

• Complete financial clearance for all referrals by determining eligibility.

• Process referrals to assure pre-qualifying of patients efficiently.

• Verifies all primary and secondary insurance information for all incoming patients to include service coverage, benefit maximums and limitations, co-insurance/co-payment, pre-existing clause, coverage

• Determine effective and termination dates, type of plan, and provider network status.

• Complete all information with attention to timely filing dates and special filing requirements.

• Analyze admission data and prepare assigned reports

• Loads all patient demographic insurance and benefit information into appropriate software system

• Communicates effectively with the referral sources and team members to support the business partnerships being developed by the sales team

• Establish positive relationships with insurers and managed care entities; Third party payors and Case Managers.

• Obtain complete and accurate information to facilitate the admissions process and to maximize the likelihood of reimbursement.

• Utilizes reports to assure accurate and timely information is documented in the appropriate software system.

• Excellent Communication, Customer Service & Time Management Skills

TRAINING, SKILLS, AND EXPERIENCE AND EDUCATION REQUIREMENTS:

• Associates Degree preferred

• 2+ years’ experience in

• Proficient in Microsoft Office, Word & Excel

• Understanding of patient compliance issues, Medicare, Medicaid and Commercial Insurance

• Excellent communication skills and customer service

• Familiarity with Medical Terminology

• Experience working in a call center environment

• Ability to multi-task, problem solve and demonstrate critical thinking skills.

**Family Makes Us Stronger.** Our family, your family, one family. Committed to loving, giving, and caring. United in making a difference.

We are eager to connect with you! **_Apply Now_** to get started at PruittHealth!

_As an Equal Employment Opportunity employer, all qualified applicants will receive consideration without regard to race, color, religion, sex, national origin, disability, or veteran status._

For Florida Job Postings Only:

For more information regarding Florida’s Care Provider Background Screening Clearinghouse Education and Awareness, please visit https://info.flclearinghouse.com