Pre Service Specialist

Pre Service Specialist

The Pre Service Specialist completes pre-registration and financial clearance functions prior to the patient's arrival for service. This role collects and validates accurate patient demographic and insurance information, obtains pre-certification/authorization as required, and enters all necessary information into the organization's electronic database. Working under direct supervision, this role is also responsible for informing the patient of his/her approximate liability, collecting patient liabilities, identifying patients in need of financial assistance and referring patients to financial counseling as necessary.

Essential Job Functions:

• Accesses scheduled patient accounts for the purpose of completing the financial clearance process to reduce financial risk by; validating authorization on file, collecting patient liability, identifying needs for financial assistance.
• Contacts the patient to obtain/validate demographics and insurance information.
• Collects and accurately documents initial pre-certification/authorization information if available.
• Ensures the ordering provider office has initiated the process for obtaining a required referral/authorization if not found on file with insurance.
• Completes insurance verification and eligibility checks and documents patient liability.
• Communicates issues or potential issues involving customer service and process improvement opportunities to management.
• Performs other duties as assigned.

Education:

• Required: High School Diploma or equivalent. Preferred: Associates degree in healthcare administration, medical office admin or related field.

Experience:

• Required: 2 or more years' experience in patient access, or a similar healthcare administrative role.