Description
As the Pre-Registration Representative, you will be responsible for:
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Pre-registers and pre-admits patients by telephone and/or in person
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Review and interpretation of insurance benefits, cash collections, interaction with public assistance programs (i.e. Medi-Cal, CCS)
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Implementation of Medicare requirements
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Collection of accurate demographic information and interaction with physicians/office personnel as well as other hospital personnel (i.e., PTU, IOU, nursing units)
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Interact with hospital departments such as Insurance Verification, Financial Counseling, Utilization Review and Patient Business Services to ensure correct and timely reimbursement
Salary Range: $30.36-$43.49 /hourly
Qualifications
We’re seeking a self-directed, detail-oriented professional with:
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Knowledge of ICD-10, CPT-4, and HCPCS codes as applied to authorization submission and claims reimbursement
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Knowledge of authorization submission and reimbursement for high cost specialty services and medication administration
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Knowledge of medical terminology to sufficiently identify various procedures to obtain optimum benefit information and reimbursement
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Knowledge of third party payor verification terminology
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Knowledge of State and Federal programs to ensure reimbursement from Medicare, Medi-Cal, CCS programs, out-of-state Medicaid, or other sponsoring agencies
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Knowledge of healthcare insurance and medication prior authorization & basic working knowledge of coding
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Strong oral and written communications skills
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Skill in typing proficiently including 10-key, focusing on accuracy and speed
Note: May be subject to test on qualifying skills
