• Promote patient, physician, customer and employee satisfaction by personal example, treating all contacts with respect.
• Support and participate in activities that foster customer service.
• Communicate and follow the organizational chain of command for notification of patient care/service issues.
• Maintain required applicable licensure, certification and education.
• Attend and successfully complete general and department orientation, in-service programs and the annual key competencies and mandatory update requirements.
• Participate actively in department staff meetings.
• Demonstrate effective verbal and written communications.
• Responsible for verifying insurance eligibility.
• Ensure the Admission Notification has been completed.

Skills: Customer Service, Patient Relations, Insurance Verification, Admission Processing, Communication Skills, Policy Compliance, Team Collaboration, Training Development

• Identify services and payers requiring authorization and ensure required authorizations are in place.
• Identify services requiring a referral and ensure it is in place.
• Identify services requiring consent forms (egg, Sterilization) and ensure signed forms are in place.
• Ensure Motor Vehicle Accident, Workers Compensation, or other Third Party Liability paperwork has been completed.
• Process real-time eligibility work queues in a timely and accurate manner.
• Process assigned denial work queues timely and accurately.
• Maintain current knowledge of and competency with numerous Federal, State and other regulatory body compliance regulations and third-party insurance plans.
• Use multiple computer applications to establish accounts and obtain verification information.
• Ensure all computer system entries are completed accurately and in a timely manner.

Skills: Authorization Management, Referral Coordination, Consent Processing, Liability Paperwork, Eligibility Processing, Denial Management, Regulatory Compliance, Data Entry Systems

• Maintain accurate, clear, concise, and complete account notes and other relevant information.
• Closely adhere to set schedules and handle time standards.
• Promote PH&S as a premier service organization by treating customers with compassion and respect.
• Identify, resolve and escalate major issues and service failures that impede success.
• Maintain confidentiality of all patient demographic, medical, and financial information, ensuring proper handling and disposal of confidential documents and adherence to HIPAA.
• Comply with all applicable Federal, State, and local laws, regulations, and requirements, as well as PH&S policies and procedures in all aspects of job performance.
• Think independently, identify and make complex decisions in a fast-paced environment.
• Actively supports and incorporates the mission and core values into daily activities.
• Treat all others with respect and demonstrate excellence, justice and compassion in daily work and relationships with others.

Skills: Account Documentation, Time Management, Customer Compassion, Issue Resolution, Data Confidentiality, Regulatory Compliance, Decision Making, Values Integration

• Maintain master schedule to ensure coordination between doctors, anesthesia, lab and insurance carriers.
• Schedule surgeries, coordinate schedules between the Surgery Center and doctors' offices.
• Gather all detailed information for the patient's chart, such as the type of procedure, supplies, special equipment required, insurance information, etc.
• Enter all patient information in the computer system.
• Schedule all surgical anesthesia services required according to the doctor's preference and availability.
• Assure that pre-certification/referrals are in order.
• Complete billing packets for CSO on a daily basis.
• Confer with OR Nurse Manager, Charge Nurse and/or Administrator to determine status of scheduled surgeries.
• Alter schedules to meet unforeseen conditions.

Skills: Schedule Coordination, Surgery Scheduling, Patient Charting, Data Entry, Anesthesia Scheduling, Precertification Management, Billing Preparation, Schedule Adjustment

• Work closely with the Administrator and CSO Credentialing person when maintaining approved privileges for each physician or as documents are updated, etc.
• Provide relief for the front business office, Receptionist and all other business functions.
• Cross-trained to fill in and effectively perform all other job descriptions.
• Interact appropriately and effectively with all patients/others regardless of age or ethnic background.
• Responsible for initiating safe practices and is knowledgeable about current center policies and procedures.
• Responsible for specific procedures and practices related to pain management, abuse and neglect, sentinel events and response, variance reporting, and response.
• Sentinel event alerts, participation in root cause analysis and other key policies and procedures.
• Assist with environmental hazard and infection control surveillance, and participate in emergency preparedness drills.
• Follow all equipment safety guidelines and be personally responsible for the knowledgeable use and care of all business equipment.

Skills: Credentialing Support, Office Coverage, Cross Training, Patient Interaction, Safety Practices, Policy Compliance, Risk Management, Equipment Safety

• Verify and update the Patient’s primary, secondary and tertiary Insurance benefit information.
• Advise Patients when their Insurance has expired and when to obtain new Insurance updates.
• Answer voicemails and respond within 24 hours.
• Serve as a source of information and communication link for patients, Physicians, and facility personnel.
• Scan and upload Insurance cards into EMR.
• Report and discuss any Insurance discrepancies with facility personnel.
• Perform clerical functions as directed by the Supervisor.
• Participate in pertinent educational offerings, training and staff meetings.
• Maintain confidentiality, security, and physical safety of medical records.
• Call and follow up on outstanding claim status.
• Collect and post Patient Payments.
• Assist with obtaining Authorizations or Letters of Agreements.

Skills: Insurance Verification, Patient Advising, Information Liaison, Document Scanning, Claims Follow-up, Payment Collection, Authorization Assistance, Record Security

• Verify patient insurance coverage in a timely manner, utilizing phone or online resources.
• Request missing documents/information via phone or fax to clinicians.
• Handle any discrepancies with eligibility or demographic errors by interacting with clinicians and patients.
• Collaborate and provide process improvement suggestions to the Supervisor and management.
• Participate in educational activities and attend regular staff and department meetings.
• Exhibit and manage excellent turnaround time in order to ensure timely authorizations.
• Perform duties wherever volume demands.
• Document activities appropriately in process notes.
• Participate in the Quality Assurance plan.
• Comply with applicable CLIA and HIPAA regulations.

Skills: Insurance Verification, Document Requests, Error Resolution, Process Improvement, Staff Participation, Authorization Management, Workflow Flexibility, Quality Compliance

• Experience in customer service or healthcare registration.
• Clerical and computer experience.
• Experience with State, Federal and other regulatory Compliance Regulations, including Medicare Secondary Payer, EMTALA, and ABN.
• Ability to establish priorities, organize work, be detail-oriented, and follow through, particularly due to the financial impact if duties are not performed in a timely and accurate manner.
• Knowledge of State, Federal and other regulatory Compliance Regulations, including Medicare Secondary Payer, EMTALA, and ABN.
• Ability to be patient, caring and understanding in dealing with patients who may be upset, confused, or difficult.
• Proven effective and respectful face-to-face, telephone and interpersonal communication skills.
• Ability to read, understand and follow oral and written instructions.
• PC Proficiency in MS Windows and Office applications.
• Knowledge of and utilizes electronic and automated work tools (e.g., online access tools to payers, work drivers).
• Must have completion of college-level medical terminology or a Medical Assistant course.
• Healthcare experience in a hospital or clinical setting, health insurance, or medical office, or previous registrar, verification, or third-party payer experience.

Qualifications: BA in Healthcare Administration with 3 years of Experience

• Experience in Patient Access, billing, insurance company work, or higher education with an emphasis in health services.
• Demonstrated knowledge of Medical Terminology work.
• Must have intermediate math skills.
• Successful completion of a data entry assessment.
• Basic understanding of web-based systems, proficiency in data entry.
• Ability to prioritize and organize workload.
• Must have sophisticated interviewing, communication and negotiation skills.
• Ability to make independent decisions.
• Ability to work hours that vary based on the needs of the organization, including evenings, weekends and holidays.
• Ability to work as a team member.

Qualifications: BS in Health Sciences with 2 years of Experience

• Working knowledge of basic medical terminology.
• Demonstrated multitasking and problem-solving skills.
• Ability to work independently in a changing environment and handle stressful situations.
• Must pass typing test with at least 50 words per minute.
• Demonstrated arithmetic and word mathematical problem-solving skills.
• Must be able to speak and write in a clear and concise manner to convey messages and ensure that the customer understands whether clinical or non-clinical.
• Must be able to successfully pass the Basic Windows Skill Assessment at 80% or higher rating.
• Able to strive for adult-to-adult relationships with colleagues, subordinates, and superiors.
• Proficient in Microsoft Word/Excel/Outlook, SMS, Epic, CSC Papers, scheduling systems (e.g., NueMD, RIS, SIS), IMS Web, Report Web, and insurance websites (e.g., BCBS, RADMD, WebMD, Wellcare, Amerigroup, UHC).

Qualifications: BS in Nursing with 4 years of Experience

• Must have basic computer skills.
• Knowledge of Microsoft Word, Excel and Google Workspace.
• Able to demonstrate problem-solving abilities.
• Excellent communication and customer relation skills.
• Ability to adhere to productivity goals and departmental guidelines.
• Strong work ethic and work independently.
• Must have the ability to multitask.
• Possess strong organizational skills.
• Understanding of  HIPAA and Red Flag guidelines.
• Able to maintain social, ethical and organizational norms.
• Able to achieve the accomplishment of all task details, no matter how small.
• Able to maintain good personal motivation, develop a sense of ownership of job tasks and results.
• Must have a sense of urgency for all work performed.
• Ability to work under the pressure of meeting strict deadlines.
• Excellent interpersonal and communication skills.

Qualifications: BA in Medical Office Administration with 2 years of Experience

• Basic personal computer skills include Microsoft Office applications.
• Knowledge of the use of a calculator.
• Proficient in the operation of scanners, copiers, and fax machines.
• Ability to handle stress.
• Ability to manage a heavy case load in an organized and efficient manner.
• Ability to recommend appropriate account adjustments and write-off suggestions.
• Ability to recognize potential accounts receivable-related problems and offer solutions to management.
• Ability to maintain a working relationship with other departments within the organization.
• Ability to review all billing transactions for accuracy, discrepancies, and appropriate charges.
• Ability to document account information at the time of account follow-up.
• Ability to run accounts receivable reports.

Qualifications: BS in Accounting with 3 years of Experience

• • Experience may be substituted for college requirements.
  • Experience in a customer-service business.
  • Experience in a hospital/medical office setting.
  • Ability to type 25 wpm.
  • Ability to prioritize and perform a multitude of duties.
  • Ability to relate to a diverse patient population.
  • Excellent telephone and customer service skills.
  • Must have critical analytical/investigative thinking skills.
  • Knowledge of basic medical terminology, as well as anatomy and physiology.
  • Knowledge of insurance concepts, practice, and procedures.
  
  
  Qualifications: BA in Human Resources Management with 2 years of Experience

• Experience in Insurance Verification or relevant schooling.
• Able to pass Level 2 background check with AHCA.
• Experience with PIP insurance.
• Knowledge of HIPAA laws and compliance.
• Previous experience, or some surgical clerical experience, or medical terminology.
• Ability to effectively present information to patients, physicians, and other employees of the surgery center.
• Must have basic math skills.
• Must have communication skills.

Qualifications: BS in Information Systems with 1 year of Experience