Pre-Admission Specialist

Job Description

Description

Summary:
The Pre-Admission Specialist is responsible for assuring appropriate insurance verification, prior approvals, and all authorization requirements are obtained prior to the patient's arrival for surgery, out-patient testing, and during the patient's observation or in- patient hospitalization. Communicates with other departments including registration, billing, scheduling and care management. Responsible for accurately updating patient benefit information in the hospital’s insurance system and verifying that existing information is correct. Makes pre-registration phone calls to pre-register patients for future services and to discuss their financial responsibility.

Responsibilities:
1. Verifies insurance eligibility and coverages for all patients.
2. Coordinates with physicians’ offices, payors, and patients (as needed) to ensure services are authorized.
3. Generates, prints, and mails estimates.
4. Contacts patients to confirm patient information, coverage, and service date as part of the pre-registration process.
5. Informs patients of their liabilities and attempts to collect payments (i.e. takes payments over the phone, etc.).
6. Submits notification for IP/OBS urgent admits.
7. Proactively identifies unauthorized visits and ensures authorization is obtained prior to the date of service.
8. Abides by the Wayne UNC – Financial Clearance Collections Policy.
9. Completes Work Queue responsibilities appropriately and timely.
10. Documents all notes and transactions appropriately.
11. Meets or exceeds goals pertaining to productivity and quality expectations.
12. Assists in training teammates from the Pre-Admission team.
13. Serves a resource and role model for other teammates in the area.

Other information:

Education

Associates degree in business or related field preferred.

Licensure/Certification

CRCR certification from HFMA within one year of hire.

Experience

Minimum of two (2) years of experience in patient access, registration, billing, insurance and/ or precertification required. Experience with insurance carriers or a third-party administrator is preferred.

Bi-lingual is a plus.

Knowledge, Skills and Abilities

• Excellent customer service and interpersonal skills with the ability to work well with the public and co-workers both in person and over the telephone.

• Ability to work with deadlines and within timelines.

• Detail oriented and organized.

• Ability to read, write and communicate effectively in English.

• Proficient with MS Office and EPIC. Able to learn new software rapidly.

Valid NC Driver’s License: No

If driving a Wayne UNC Vehicle, must be 21 years old and MVR must be approved by Risk Management.

BO-213

01.8524.BO-213.NON-CLIN

Job Details

Legal Employer: Wayne Health

Entity: Wayne UNC Health Care

Organization Unit: Admitting

Work Type: Full Time

Standard Hours Per Week: 40.00

Work Assignment Type: Hybrid

Work Schedule: Day Job

Location of Job: WAYNE MED

Exempt From Overtime: Exempt: No