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Pre-Registration/Insurance Verification Representative (Pre-Visit Services) Bi-lingual preferred

OU Health Edmond, OK (Onsite) Full-Time

Position Title:

Pre-Registration/Insurance Verification Representative (Pre-Visit Services) Bi-lingual preferred

Department:

OUHP Pre-visit Services

Job Description:

General Description: Responsible for timely and accurate pre-registration and insurance verification. Accurately interprets managed care contracts.

Essential Responsibilities:

  • Performs pre-registration and insurance verification within 24 hours of receipt of reservation/notification for both inpatient and outpatient services
  • Follows scripted benefits verification and pre-certification format in Meditech custom benefits screen and record benefits and pre-certification information therein
  • Contacts physician to resolve issues regarding prior authorization or referral forms
  • Assigns plans accurately
  • Performs electronic eligibility confirmation when applicable and document results
  • Researches Patient Visit History to ensure compliance with payor specific payment window rules
  • Completes Medicare Secondary Payor Questionnaire as applicable for retention in Abstracting module
  • Calculates patient cost share and be prepared to collect via phone or make payment arrangement
  • Contacts 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
  • Receives and records payments from patient for services scheduled.
  • Utilizes appropriate communication system to facilitate communication with hospital gatekeeper
  • Performs 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
  • Utilizes Meditech account notes and Collections System account notes as appropriate to cut and 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
  • Practices and adheres to the “Code of Conduct” philosophy and “Mission and Value Statement”

General Responsibilities:

  • Other duties as assigned

Minimum Qualifications:

Education: High school diploma or GED required

Experience:  At least three years of insurance verification experience preferred

License(s)/Certification(s)/Registration(s) Required:  N/A

Knowledge, Skills and Abilities:

  • Communication - communicates clearly and concisely, verbally and in writing
  • Customer orientation - establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations
  • Interpersonal skills - able to work effectively with other employees, patients and external parties
  • PC skills - demonstrates proficiency in PC applications as required
  • Policies & Procedures - demonstrates knowledge and understanding of organizational policies, procedures and systems
  • Basic skills - able to perform basic mathematical calculations, balance and reconcile figures, punctuate properly, spell correctly and transcribe accurately

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OU Health is an equal opportunity employer. We offer a comprehensive benefits package, including PTO, 401(k), medical and dental plans, and many more. We know that a total benefits and compensation package, designed to meet your specific needs both inside and outside of the work environment, create peace of mind for you and your family.

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Job Snapshot

Employee Type

Full-Time

Location

Edmond, OK (Onsite)

Job Type

Insurance

Experience

Not Specified

Date Posted

01/10/2025

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