Job Information
MERCY HEALTH CORPORATION Precertification Specialist in JANESVILLE, Wisconsin
JOB REQUIREMENTS: Essential Duties and Responsibilities Ensures all scheduled visits are pre-registered and accounts are appropriately certified / authorized in advance of the service date. Initiates, obtains, and documents referrals/authorizations/pre-certifications in appropriate systems. Answers incoming external/internal telephone calls, determines purpose of calls and schedules appropriately or routes to physician practices or other departments as appropriate. Registers new and returning patients via multiline phone lines, and various Mercy systems/applications for visits within the Mercyhealth System ensuring that all required elements are gathered to ensure payment for the service provided. Initiates outbound calls to external providers, patients, and/or payers based on referrals entered into the system and schedules appropriately. Communicates with provider\'s office as needed. Ensures compliance with Access and Revenue Cycle related policies and procedures. Manages waitlists, rescheduling/cancellation of appointments as necessary. Completes accounts in assigned WQ\'s. Manages patient initiated scheduling requests through MyChart, Telehealth, or other self-scheduling applications. Maintains a high level of professionalism and provides a quality patient experience. Schedules appointments appropriately according to provider and clinic based protocols. Performs ancillary tasks by providing outreach to patients. Must have excellent customer service skills. Answers questions about organization and provides callers with address, directions and other information about the site that they are scheduled for. Able to articulate information in a manner that patients, guarantors, and family members understand. Ensures compliance with reporting related to demographics and federal and state requirements. Has in depth knowledge of community based, state or federal government programs to provide assistance to patients who have limited or no ability to pay for their health care needs. Screens patients and provides assistance with completion of applications, if necessary. Serves as a liaison to clinical staff by maintaining good communication regarding any problems and/or resolutions to patient issues or access concerns. Contacts insurance companies or employer groups via phone, web portals, electronic applications, or other appropriate means to determine eligibility and benefits for necessary services to obtain financial resolution and guarantee payment on account. Maintains current knowledge of payor payment provisions and regulations to ensure correct data is gathered and documented. Provides financial information to patients, which includes patient financial obligations, estimated costs of services, billing practices and establishing payment arrangements as necessary. Collects co-pays,... For full info follow application link. EOE&AA/M/F/Vet/Disabled. Mercy is an equal employment opportunity employer functioning under Affirmative Action Plans. ***** APPLICATION INSTRUCTIONS: Apply Online: ipc.us/t/6976AADF18DB4681