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Posted: Wednesday, May 17, 2017 8:11 PM

GENERAL SUMMARY OF DUTIES - Responsible for timely and accurate pre-registration and insurance verification. Accurately interprets managed care contracts and is proficient in the use of the Contrak system.
DUTIES INCLUDE BUT ARE NOT LIMITED TO:
  • Retrieve reservation/notification of scheduled admission from gatekeeper via laser printer
  • Perform pre-registration and insurance verification within 24 hours of receipt of reservation/notification for both inpatient and outpatient services
  • Follow scripted benefits verification and pre-certification format in Meditech custom benefits screen and record benefits and pre-certification information therein
  • Contact physician to resolve issues regarding prior authorization or referral forms
  • Assign Iplans accurately, via the use of the Contrak system
  • Perform electronic eligibility confirmation when applicable and document results
  • Research Patient Visit History to ensure compliance with the Medicare 72 hour rule
  • Complete Medicare Secondary Payor Questionnaire as applicable for retention in Abstracting module
  • Calculate patient cost share and be prepared to collect via phone or make payment arrangement
  • Contact patient via phone (with as much advance notice as possible, preferably 48 hours prior to date of service) to confirm or obtain missing demographic information, quote/collect patient cost share, and instruct patient on where to present at time of appointment
  • Receive and record payments from patient for services rendered.
  • Utilize Meditech MOX communication system to facilitate communication with hospital gatekeeper
  • Perform insurance verification and pre-certification follow up for prior day's walk in admissions/registrations and account status changes by assigned facility
  • Communicates with hospital based Case Manager as necessary to ensure prompt resolution of pre-existing, non-covered, and re-certification issues
  • Utilize Meditech account notes and Collections System account notes as appropriate to cut-n-paste benefit and pre-authorization information and to document key information
  • Meets/exceeds performance expectations and completes work within the required time frames
  • Implements and follows system downtime procedures when necessary
  • Practice and adhere to the "Code of Conduct" philosophy and "Mission and Value Statement"
  • Other duties as assigned

Click here for more info: https://hca.taleo.net/careersection/0hca/jobdetail.ftl?job=08948-133378&lang=en


• Location: Houston

• Post ID: 54711628 houston
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