Job Summary

Provides seamless pre-registration for scheduled ambulatory appointments and hospital scheduled admissions. Completes insurance verification. Documents any out-of-pocket expenses and acquire any necessary referrals. Reviews insurance benefits with patient and attempts to collect copays, deductible and coinsurance along with outstanding balance and pre-service payments to contribute to department point of service collections.

Job Duties

• The expectation is that a complete and accurate pre-registration is done while maintaining HIPAA guidelines when contacting the patient via phone to verify the demographics and insurance information.
• The Financial Clearance Specialist will discuss any out-of-pocket expense along with any outstanding balance or pre-service payment with an attempt to collect on these services.
• If the patient is requesting payment options, the call can be transferred to department Financial Counselors.
• Performs insurance verification for various payers by utilizing passport and manual processes to ensure patients electronic medical record contains the accurate insurance information.
• For those insurances that cannot be processed through automated systems a phone call is placed to the insurance carrier to obtain eligibility and out-of-pocket expenses.
• Reviews and selects the appropriate insurance and visit indicator to ensure the correct insurance is billed for cadence appointments.
• For Hospital scheduled admission appointments the correct coverage would need to be prioritized and then listed on the HAR to ensure correct insurances are being billed.
• Reviews and or requests referrals as needed for future appointments by sending telephone encounters to Geisinger Primary Care Provider's(PCP) and contacting outside PCP offices by fax to request referrals.
• Completes Medicare Secondary Payer Questionnaire for all patients meeting the criteria.
• Enters Financial Comments and Financial Clearance indicator in the appointment info tab in software system utilizing the financial abbreviations to advise staff what has been completed with the account.
• Information would consist of demographics status, insurance verification, referrals and any necessary forms that need to be signed by the patient.
• Codes utilized for documenting this process have been established by the department.
• For Hospital Scheduled Admissions documentation is completed in authorization and certification tab.
• Advises supervisor of unusual circumstances, situations or issues to get them resolved.
• Reviews and explains all necessary forms that require signatures from patients upon arrival such as Assignment of Benefits (AOB), Universal Auth (UA), Privacy Acknowledgment (PACK), Notice of Financial Responsibility (NOFR).
• Responsible for meeting the goals set for productivity, quality and Point of Service (POS) Collections.
• Functions as a team member to organize and prioritize individual assigned work queues.
• Aids coworkers for all work queues to be completed to department timeframes.
• Makes suggestions for improvements to procedures or innovations to heighten patient experience.

Work is typically performed in an office environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job.

Position Details

Education

High School Diploma or Equivalent (GED)- (Required)

Experience

Minimum of 1 year-Related work experience (Preferred)

Certification(s) and License(s)

OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities. KINDNESS: We strive to treat everyone as we would hope to be treated ourselves. EXCELLENCE: We treasure colleagues who humbly strive for excellence. LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow. INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation. SAFETY: We provide a safe environment for our patients and members and the Geisinger family We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners. Perhaps just as important, from senior management on down, we encourage an atmosphere of collaboration, cooperation and collegiality. We know that a diverse workforce with unique experiences and backgrounds makes our team stronger. Our patients, members and community come from a wide variety of backgrounds, and it takes a diverse workforce to make better health easier for all. We are proud to be an affirmative action, equal opportunity employer and all qualified applicants will receive consideration for employment regardless to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or status as a protected veteran.

We are an Affirmative Action, Equal Opportunity Employer Women and Minorities are Encouraged to Apply. All qualified applicants will receive consideration for employment and will not be discriminated against on the basis of disability or their protected veteran status.

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