Top 2 Prior authorization specialist Jobs in Cuero, Tx

PA Representative
CUERO REGIONAL HOSPITAL —Cuero, TX
- 12 hour shift
- Background check
- Surgery
- Customer service
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PA Representative

CUERO REGIONAL HOSPITAL
Cuero, TX

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Job Details

Qualifications

Customer service
Word processing
High school diploma or GED

Full Job Description

Category:

Patient Access

Department:

Patient Access

Status:

PRN

Schedule:

12 hour shifts including nights & weekends

Description:

Cuero Regional Hospital is searching for a PRN Representative in our Patient Access Department.

Job Description:

Patient Access Representatives are responsible for guiding patients through the admissions process by screening patients for eligibility, preparing patient information for clinical staff, and answering patient questions.
These representatives also get patients ready for intake, process them during admission, and guide them through discharge.
Patient Access Reps are responsible for timely and accurate patient registration. Interviews patients for all pertinent account information.
Verify all insurance and calculates and collects patient liability amounts.
Ensure that all necessary signatures are obtained for treatment.
Answer any questions and explain policies clearly.
Check for physician orders and attaches them to appropriate patient record to ensure correct test is received. Print and collate any paperwork needed for each patient to for distribution to unit/department.
Escorts patients to his/her area or refers patient to available escort as needed.
Patient Access Representatives must have strong interpersonal skills to communicate with patients and clinical staff effectively.
Digital experience with word processing programs is also essential to the role of a Patient Access Representative.
Although extensive clinical training is not necessary for this position, incoming candidates will be guided through courses related to the services of the facility.
The Referral & Authorization Specialist completes authorizations and referrals for services, including appointments, and procedures.
The departments role is to complete or verify that authorization and referrals for medical services provided in the healthcare system as been achieved.
In addition to reviewing the medical history of the potential patients, you verify information provided by the referring physicians and verify their insurance coverage.
The specialist monitors the schedule for add-on patients, ensuring there are no conflicts and that we have the prior authorization needed to move forward with their appointment or procedure.
Inputs new patient information and update information in our electronic health record systems. Responsible for organizing and scheduling procedures according to physicians requests and facility guidelines.
Complete billing documentation and assist where other tasks as assigned.
The Collections Clerk is responsible for working with the Financial Counselor to improve self pay collections for all patients.
They review all SP Emergency patients and perform follow up with phone calls or letters for capture of any missed insurances, and to offer self pay discounts when appropriate.
They assist with review of self pay collections, reviewing bills of patients that have received 3 statements without payment, sending letters, making phone calls and referring to correct collection agency per set policy.
They assist with determining and collecting payments and copays for outpatient imaging and day surgery procedures.
They back up Verification clerk, in obtaining insurance verification and preauth for tests and surgeries.
They review inpatients and observation list and go to floor to collect SP portions. The assist with collections in ER and outpatient lab and training registration clerks to perform collection duties.
They back up Financial counselor with computing self pay amounts and calling for payments. They assist with charity care applications and indigent applications.
Under the direction of the department manager, responsible for all duties related to the scheduling cycle and pre-registration, while using multiple programs and resources.
Work under conditions of constant interruption and subject to time pressure and process change requirements.
Facilitate all components of the patient’s scheduled procedure prior to patient presentation for scheduled visit. Communicate the hospitals’ financial policies and other required documents to all patients.
Identify patients who require financial counseling.
Knowledge of Advance Beneficiary Notice, ICD10 coding, CPT codes, general anatomy, and medical terminology.
Communicate with provider offices, co-workers and other service areas and employees.
Responsible for understanding authorization and medical necessity at time of scheduling the appointment.
The important role of the Patient Access Representative (PAR) directly impacts the revenue cycle by accurately processing data relating to insurance and demographic information on patients, while following unit specific policies.
They must maintain current knowledge of payer insurance requirements.
The PAR may initiate the process and assess surgical and diagnostic patient information to be systematically available hospital wide.
The PAR meets established quality and productivity standards and interacts professionally with MD's, MD office staff, employees, outside vendors, patients, and patient representatives.

Qualifications:

High school diploma or GED
3 months customer service minimum
Medical terminology preferred
2 year healthcare care setting. Knowledge of EXPANSE and Patient Access Department preferred

Closing:

Open until filled

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