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.

Education

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

Experience

Minimum of 1 year-Relevant experience* (Required)

Skills

Computer Literacy; Communication; Teamwork; Time Management

About Geisinger

Founded more than 100 years ago by Abigail Geisinger, the system now includes ten hospital campuses, a 550,000-member health plan, two research centers and the Geisinger Commonwealth School of Medicine. With nearly 24,000 employees and more than 1,700 employed physicians, Geisinger boosts its hometown economies in Pennsylvania by billions of dollars annually. Learn more at geisinger.org or connect with us on Facebook, Instagram, LinkedIn and Twitter.

Equal Opportunity Employer

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, pregnancy, genetic information, disability, status as a protected veteran, or any other protected category under applicable federal, state, and local laws.

Our Vision & Values

Everything we do is about making better health easier 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.

Our Benefits

We offer healthcare benefits for full time and part time positions from day one, including vision, dental and prescription coverage.