Insurance Pre-Registration Specialist - Full time - Memorial Health System - Springfield, IL

Insurance Pre-Registration Specialist - Full time - Memorial Health System - Springfield, IL -

Primary Perform: Liable for appropriately prioritizing and finishing all steps of pre-registration for scheduled sufferers by way of telephone or on-line registration, previous to receipt of providers. Identifies, verifies, and captures applicable affected person demographic info and well being insurance profit eligibility. Performs payer protection investigation, as vital, using each inner and exterior instruments and assets, to acquire reimbursement verification. Makes use of information together with, however not restricted to, managed care, business, authorities, and work comp insurance billing necessities, in addition to present coding tips and requirements, to make sure decision of pre-service edits, applicable management of claims, initiation and path of accounts for pre-authorization as required, prevention of well timed submitting declare denials, and procurement of applicable reimbursement. This place requires primary understanding of healthcare Income Cycle and the significance of evaluating and securing all applicable monetary assets to maximise reimbursement to the well being system. This place assumes medical and monetary danger of the group when accumulating and documenting info on behalf of the affected person.

Necessities:
Highschool diploma or equal required.

One yr of healthcare registration, scheduling, or physicians workplace expertise required. Completion of 24 (twenty 4) hours of coursework in a enterprise or healthcare associated area of research could also be thought-about in lieu of healthcare workplace expertise.

Medical Terminology, CPT, ICD-10 expertise most popular.

Consciousness of well being care business enterprise tendencies and developments together with, however not restricted to, Health Care Reform.

Have to be proficient with Microsoft Workplace Suite, together with Outlook, Excel and Phrase. Should have enough pc expertise to finish on-line studying necessities for job-particular competencies, entry on-line varieties and insurance policies, full on-line advantages enrollment, and electronically notate registration software program, and different required purposes/techniques.

Demonstrated capability to speak clearly and concisely, each verbally and in writing, with friends, supervisors, payers, physicians, sufferers, different departments.

Talent in analyzing info, issues, conditions, practices, and procedures; figuring out patterns and tendencies/ trigger-and-impact relationships; formulating logical and goal conclusions; and recognizing options and their implications, so as to formulate complete options.

Expertise with and/or working information of Name Middle processes most popular.

Demonstrated capability to stay versatile, and persistently train sound judgment and initiative in traumatic conditions. Means to successfully handle competing priorities and work independently, with minimal supervision.

Should show capability to teach, persuade, and negotiate successfully with sufferers and households towards compliance with payer necessities and collections objectives.

Flexibility of hours mandatory to make sure enterprise wants are met. Acknowledges the necessity for change in every day routines resulting from staffing, cross coaching, departmental necessities, and so on. and supplies protection, completes assignments earlier than leaving.

Potential to course of a mean of 40 scheduled affected person accounts/visits per day.

Required Expertise

Required Expertise

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