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Posted: Sunday, July 16, 2017 11:33 AM

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.
  • 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

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• Location: Houston

• Post ID: 60468023 houston is an interactive computer service that enables access by multiple users and should not be treated as the publisher or speaker of any information provided by another information content provider. © 2017