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Description

As the Pre-Registration Representative, you will be responsible for:

Pre-registers and pre-admits patients by telephone and/or in person
Review and interpretation of insurance benefits, cash collections, interaction with public assistance programs (i.e. Medi-Cal, CCS)
Implementation of Medicare requirements
Collection of accurate demographic information and interaction with physicians/office personnel as well as other hospital personnel (i.e., PTU, IOU, nursing units)
Interact with hospital departments such as Insurance Verification, Financial Counseling, Utilization Review and Patient Business Services to ensure correct and timely reimbursement

Salary Range: $30.36-$43.49 /hourlyQualifications

We’re seeking a self-directed, detail-oriented professional with:

Knowledge of ICD-10, CPT-4, and HCPCS codes as applied to authorization submission and claims reimbursement
Knowledge of authorization submission and reimbursement for high cost specialty services and medication administration
Knowledge of medical terminology to sufficiently identify various procedures to obtain optimum benefit information and reimbursement
Knowledge of third party payor verification terminology
Knowledge of State and Federal programs to ensure reimbursement from Medicare, Medi-Cal, CCS programs, out-of-state Medicaid, or other sponsoring agencies
Knowledge of healthcare insurance and medication prior authorization & basic working knowledge of coding
Strong oral and written communications skills
Skill in typing proficiently including 10-key, focusing on accuracy and speed

Note: May be subject to test on qualifying skills

Pre-Registration Representative