Maintains an understanding of payer rules and requirements for insurance authorizations.
Utilize EPIC report/work queue to ensure all components of the scheduling requirements are met prior to service in an effort to reduce patient wait times and complaints related to eligibility, authorization or referral.
Monitors work queue activity to ensure timely resolution.
Document all activity on the patient account and appropriately document and gather patient demographics/insurance information.
Participates in staff training to increase understanding of specific payer requirements, scheduling protocols and general functionality.
Adheres to productivity and quality measures as outlined by management.
Maintains an understanding of EPIC within the scope of the job performed.
Works with the assigned payer to achieve resolution
Schedules patients appropriately based upon location instructions, patient demographics and payer requirements.
Assures that paperwork in patient's chart is accurate.
Answer's phones to and/or from clinics, hospital departments, insurance companies and patients, as well as scheduling, insurance and pre-registration duties.
Post payments and adjustments into EPIC timely and accurately.
Collects pre-service, past due and bad debt amounts.
Obtains pre-certification/referral from insurance companies for patients to have an office visit, procedure, direct admit or surgery. Verifies the patient is covered by insurance plan and benefits will cover specifics requested.
Must have high school diploma or equivalent. Prefer candidate with an Associate's degree in Medical Office Management or similar field.
Candidate must have a minimum of 1 year of experience working in an office setting. Prefer experience in a medical office environment. Also prefer candidate with 1-2 years of experience with health insurance.
Prefer candidate with a strong knowledge in medical terminology.
Must be comfortable using a computer and have basic typing and computer skills (data entry, word processing and 10 key).
Candidate must be self-motivated, self-directed and dependable. Must have excellent customer service and strong problem-solving and organizational skills.
CHRISTUS HEALTH is an international Catholic, faith-based, not-for-profit health system comprised of almost more than 600 services and facilities, including more than 60 hospitals and long-term care facilities, 350 clinics and outpatient centers, and dozens of other health ministries and ventures. CHRISTUS operates in 6 U.S. states, Colombia, Chile and 6 states in Mexico. To support our health care ministry, CHRISTUS Health employs approximately 45,000 Associates and has more than 15,000 physicians on medical staffs who provide care and support for patients. CHRISTUS Health is listed among the top ten largest Catholic health systems in the United States.