Pre-Service Specialist II

Department/Unit:
Patient Access

Work Shift:

Day (United States of America) Salary Range: $46,947.00 - $65,726.00 The Pre-Service Specialist II (PSS II) is the initial point of contact for our patient population to provide an exceptional patient experience with assisting in scheduling of the more complex services for our Hospital and Practice. Strong knowledge of insurance payer authorization guidelines is critical for the financial clearance and payment of services.

Position requires ability to work in a high-volume contact center, fast-paced environment. Understanding complex scheduling needs of our patients in an empathetic, compassionate manner is critical. Position is required to use eligibility application to invoke request to verify insurance eligibility, interpret response and capture appropriate health insurance information as it pertains to the service being rendered. The position requires ability to understand and apply contractual benefits to the service being rendered, with ability to collect patient financial obligation pre-services.

• Responsible for scheduling appointments and services for multiple service lines (PODs) via the scheduling system following established scripting and protocols promoting physician satisfaction and scheduling efficiencies on behalf of our patients.
• Ability to identify trigger words, symptoms and patient concerns, assuring calls are triaged to the respective Clinic Nursing team per protocol.
• Responsible for discerning demographic and insurance information to ensure accurate registration
• Responsible to interpret information received from Insurance Payer regarding patient’s eligibility and financial responsibility
• Responsible for discussing financial obligation of patient and collect via cash, credit card or check
• Ability to accurately interpret referral/physician order to meet the patient and/or provider need for scheduling of services correctly.
• Responsible for scanning or managing online form template to maintain the Electronic Health Record
• Comprehend Federal, State, Third Party Payer regulations as it pertains to a hospital and practice pre-registration.
• Ability to work in multiple systems during a telephone call or patient facing interaction to complete an accurate registration and support clinical workflow.
• Responsible for review of services being rendered to ensure the appropriate setting of care has been assigned by the physician’s office
• Obtains all insurance information from patient and verifies insurance to ensure active coverage for services being scheduling.
• Provides thorough comments, where applicable for all conversations with patients or providers.
• Ability to train adult learners using an operational training manual

• High School Diploma/G.E.D.
  
  - required
• Winning customer service personality with ability to engage patients, provider and provider staff as well as insurance company representatives via telephone with superior patient experience.
• 3– 5 years’ experience in Hospital or Physician office experience or call center environment, - preferred
• Strong insurance knowledge specific to complex scheduling needs and authorization management
• Critical thinking ability
• Ability to provide cross coverage where and as needed
• Proven customer service skill with ability to exceed expectations
• Ability to multi-task in stressful and high patient volume unit
• Must be able to manage daily productivity, quality and accuracy targets
• Ability to maintain composure under pressure
• Ability to review information and draw appropriate conclusion
• Good judgement and ability to be resourceful to problem solve; escape issues as needed
• Team minded work ethic
• Demonstrated ability interpret patient’s insurance benefits and apply the…