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Employment Type : Full-Time
Nuvance Health has a network of convenient hospital and outpatient locations — Danbury Hospital, New Milford Hospital, Norwalk Hospital and Sharon Hospital in Connecticut, and Northern Dutchess Hospital, Putnam Hospital Center and Vassar Brothers Medical Center in New York — plus multiple primary and specialty care physician practices locations, including The Heart Center, a leading provider of cardiology care, and two urgent care offices. Non-acute care is offered through various affiliates, including the Thompson House for rehabilitation and skilled nursing services, and the Home Care organizations.
Summary:
Facilitates patient flow through the pre-registration process, including scheduling and financial clearance, for WCHN and WCMG, so that patients have a "one touch" pre-registration experience. Responsible for obtaining demographic and financial information to ensure accurate patient identification and identify and secure appropriate payment sources. Performs pre-registration functions and insurance eligibility verification. Provides estimates for services when appropriate. Receives and processes patient financial liability payments.
Responsibilities:
1. May be assigned to schedule patients, either by signing into Avaya telephone queue and taking incoming calls, or placing outbound calls to patients. Answers all incoming phone calls in a timely manner. Provides excellent customer service both to physician offices and patients.
2. Utilizes electronic scheduling and patient financial systems (such as Soarian Financials, Soarian Scheduling, and Cerner) to schedule patients in a timely, yet accurate, manner. Offers first available appointment which is appropriate for testing that patient needs.
3. May review patient clinical information in electronic medical record (EMR) system to determine correct test to be scheduled.
4. Performs insurance eligibility verification and executes payor requirements as needed. Includes initiating eligibility transactions via the Internet, contacting the payor to obtain billing information and authorization and scripts for service when appropriate.
5. Initiates requests for authorizations, pre-certifications, notices of admission, and referrals from insurance companies. Utilizes Electronic Medical Record (EMR) system to obtain necessary clinical information to secure such precertification. Follows up with payers to ensure that authorizations are in place prior to time of service. Takes appropriate steps to remediate situations in which financial clearance is not completed prior to time of service to ensure that WCHN (hospitals and medical group) receive prompt payment for services rendered.
6. Obtains accurate insurance benefit information from payers, such as deductible, copay, and coinsurance amounts. Utilizes patient estimation tool to calculate estimate of patient liabilities. Requires an understanding of coding, procedural protocols and the charge description master.
7. Contacts patients to perform pre-registration, including demographic verification, conveyance of insurance benefits, and estimates of liabilities. Collects on such liabilities prior to time of service utilizes provided scripting.
8. Receives incoming faxed physician orders. Verifies orders for compliance and accuracy. Contacts patients to schedule and perform pre-registration, including demographic and insurance verification. Archives orders into appropriate systems.
9. Performs accurate search/selection of patient within the hospital system to maintain the integrity of the Electronic Master Patient Index (EMPI) and to ensure the accuracy of patient identification.
10. May schedule appointments for services from patients directly or physician’s offices following the designated protocols of the scheduling systems (Soarian Scheduling, Soarian Financials, Cerner, Athena, etc.).
11. Performs pre-registration functions in the system and enters accurate and complete demographic and financial information to aid in securing payment for services rendered.
12. Responds to telephone calls according to established customer service standards. Provides requested information to callers.
13. May initiate contact to patients to obtain additional information or confirm scheduled appointments.
14. Contributes to reduction of abandoned call rate, length of calls, and average speed answered through use of best practices and workflow improvements as defined by Scheduling Supervisor and Contact Center Manager.
15. Fulfills all compliance responsibilities related to the position.
16. Performs other duties as assigned.
Other information:
Required: Data entry required. Customer service and organizational skills. Minimum Experience: zero to six months Desired: Medical terminology. Basic level MS Word & MS Excel. Experience with insurance.
Location: Bethel-20 Stony Hill Rd
Work Type: Full-Time
Standard Hours: 40.00
FTE: 1.000000
Work Schedule: Day 8
Work Shift: Variable hours between 8am - 8pm M-F, occasional weekends as needed
Org Unit: 269
Department: Corporate Financial Clearance
Exempt: No
Education:
Essential:
Working conditions:
Essential:
Nuvance Health and its affiliates are Section 501(c)(3) tax-exempt organizations and therefore eligible employees may qualify for forgiveness of certain federal student loans under the Public Service Loan Forgiveness Program.
WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Qualified Applicants are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, marital status or any other classification protected under applicable Federal, State or Local law.
We will endeavor to make a reasonable accommodation to the known physical or mental limitations of a qualified applicant with a disability unless the accommodation would impose an undue hardship on the operation of our business. If you believe you require such assistance to complete this form or to participate in an interview, please contact Human Resources at 203-739-7330 (for reasonable accommodation requests only). Please provide all information requested to assure that you are considered for current or future opportunities.