DUTIES INCLUDE BUT ARE NOT LIMITED TO:
• Retrieve reservation/notification of scheduled admission from gatekeeper via laser printer
• Perform pre-registration and insurance verification within 24 hours of receipt of reservation/notification for both inpatient and outpatient services
• Follow scripted benefits verification and pre-certification format in Meditech custom benefits screen and record benefits and pre-certification information therein
• Contact physician to resolve issues regarding prior authorization or referral forms
• Assign Iplans accurately, via the use of the Contrak system
• Perform electronic eligibility confirmation when applicable and document results
• Research Patient Visit History to ensure compliance with the Medicare 72 hour rule
• Complete Medicare Secondary Payor Questionnaire as applicable for retention in Abstracting module
• Calculate patient cost share and be prepared to collect via phone or make payment arrangement
• Contact 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
• Receive and record payments from patient for services rendered.
• Utilize Meditech MOX communication system to facilitate communication with hospital gatekeeper
• Perform 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 preexisting, non-covered, and re-certification issues
• Utilize Meditech account notes and Collections System account notes as appropriate to cut-n-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
• Practice and adhere to the "Code of Conduct" philosophy and "Mission and Value Statement"
• Other duties as assigned