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Full-time
high school
Posted 2d ago
~40 hrs/week
Responsibilities
The specialist is responsible for pre-registering patients, verifying insurance coverage, and obtaining necessary authorizations for hospital services. They also manage pre-service collections and ensure accurate documentation of demographic and third-party payer data.
Requirements
Candidates must have a High School Diploma or GED. Preferred qualifications include at least one year of experience with Epic software and prior experience in pre-registration or prior authorization.
Full job description
Position Title
Pre-Reg Pre-Cert SpecialistWestwood Administration - East
Position Summary / Career Interest:
The Pre-Reg/Pre-Cert Specialist is responsible for identifying patients who qualify for pre-registration to include all new patients and all return patients. This position obtains identification to assure accuracy of demographic and insurance information and enters all information into the registration system. The Pre-Reg/Pre-Cert Specialist is responsible for pre-service collections and documentation when applicable. This role is responsible for verification and pre-certification, notification and authorization of all admissions and / or outpatient visits. For all sponsored admissions, will contact patients' employer and/or insurance company to verify coverage and benefits, obtain benefit level, patient liability, billing address.Responsibilities and Essential Job Functions
Works reports daily according to duty specifications to retrieve all un-contacted patients prior to service. Utilizes worklists to pre-register / pre-certify hospital services.
Conducts telephone interviews as needed with patients to elicit demographic information and third-party payer data that will be needed for billing purposes.
Enters patient data directly into registration systems. Ensures that MSPQ is completed when appropriate.
Verifies with third party payor dependent eligibility, certificate and group numbers, co-payment and deductible amounts, statement mailing address, etc. Complies with Medicare / Medicaid and other insurance rules and regulations.
Works closely with the clinics, hospital ancillary departments, and patient financial advisors regarding potential complications regarding insurance coverage.
Secures accounts per established departmental policy. This includes but is not limited to, contacting the patient, contacting responsible payers including government and non-government payers, contacting the patient’s employer, referring uninsured and underinsured accounts to the Financial Advisors, and taking any other necessary actions. Contact provider office immediately of any restrictions denying services, such as inability to obtain pre-certification or any lock-in program by any agency.
Must be able to perform the professional, clinical and or technical competencies of the assigned unit or department.
These statements are intended to describe the essential functions of the job and are not intended to be an exhaustive list of all responsibilities. Skills and duties may vary dependent upon your department or unit. Other duties may be assigned as required.
Required Education and Experience
High School Graduate or GED.
Preferred Education and Experience
1 or more years of experience in Epic.
1 or more years of prior experience in pre-registration or prior authorization.
Time Type:
Full time
Job Requisition ID:
R-53134
Important information for you to know as you apply:
The health system is an equal employment opportunity employer. Qualified applicants are considered for employment without regard to race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, ancestry, age, disability, veteran status, genetic information, or any other legally-protected status. See also Diversity, Equity & Inclusion.
The health system provides reasonable accommodations to qualified individuals with disabilities. If you need to request reasonable accommodations for your disability as you navigate the recruitment process, please let our recruiters know by requesting an Accommodation Request form using this link asktalentacquisition@kumc.edu.
Our Vision: To lead the nation in caring, healing, teaching and discovering. Join us.
Industry
Hospitals and Health Care
Company size
10,001+ employees
Founded
1998
Headquarters
Kansas City, KS
LinkedIn followers
45,475
Total funding
$6M
The University of Kansas Health System in Kansas City is a world-class academic medical center and destination for complex care and diagnosis. We offer more options for patients with serious conditions because of our expertise and leadership in medical research and education. Our physicians are researchers and educators expanding the boundaries of medical knowledge. Their major breakthroughs lead to the life-changing treatments and technologies of the future.
Our hospital has a national reputation for doing things right, and we are rated among the country’s top hospitals in quality and the patient experience.
With each step we take to become the nation's best, we establish ourselves as a healthcare destination. People from throughout the region and across the country turn to us to receive exceptional, specialized care for complex conditions. All of this is possible because of the dedication and commitment of the people who work here and our steadfast focus on caring for the patient.
We invite you to join us as we continue to advance the power of academic medicine.
Offices: 3901 Rainbow Blvd., Kansas City, KS 66160, US · 2330 Shawnee Mission Pkwy, Westwood, KS 66205, US · 10710 Nall Ave, Overland Park, Kansas, US
CancerEarNose & ThroatGeriatricsHeart Care and Heart SurgeryOrthopedicsUrologyDiabetes & EndocrinologyGastroenterology & GI SurgeryGynecology
Our Vision: To lead the nation in caring, healing, teaching and discovering. Join us.
Industry
Hospitals and Health Care
Company size
10,001+ employees
Founded
1998
Headquarters
Kansas City, KS
LinkedIn followers
45,475
Total funding
$6M
The University of Kansas Health System in Kansas City is a world-class academic medical center and destination for complex care and diagnosis. We offer more options for patients with serious conditions because of our expertise and leadership in medical research and education. Our physicians are researchers and educators expanding the boundaries of medical knowledge. Their major breakthroughs lead to the life-changing treatments and technologies of the future.
Our hospital has a national reputation for doing things right, and we are rated among the country’s top hospitals in quality and the patient experience.
With each step we take to become the nation's best, we establish ourselves as a healthcare destination. People from throughout the region and across the country turn to us to receive exceptional, specialized care for complex conditions. All of this is possible because of the dedication and commitment of the people who work here and our steadfast focus on caring for the patient.
We invite you to join us as we continue to advance the power of academic medicine.
Offices: 3901 Rainbow Blvd., Kansas City, KS 66160, US · 2330 Shawnee Mission Pkwy, Westwood, KS 66205, US · 10710 Nall Ave, Overland Park, Kansas, US
CancerEarNose & ThroatGeriatricsHeart Care and Heart SurgeryOrthopedicsUrologyDiabetes & EndocrinologyGastroenterology & GI SurgeryGynecology