Patient Service Center Rep - Remote Prior Authorizations

JOB SUMMARY

The Patient Service Center Representative II is responsible for creating a positive patient experience by accurately and efficiently handling the day-to-day operations relating to both Financial Clearance and Scheduling of a patient.  This includes adherence to department policies and procedures related to verification of eligibility/benefits, pre-authorization requirements, available payment options, financial counseling and other identified financial clearance related duties in addition to full scheduling duties.  Upon occasion, the PSC REP II may be only assigned to complex pre-registration.  The PSC REP II is expected to develop a thorough understanding of assigned fuschednction(s).  

ESSENTIAL DUTIES AND RESPONSIBILITIES

Include the following. Others may be assigned.

Completes both scheduling functions and registration functions with the patient for an upcoming visit during one call: 

• Scheduling:  Responsible for timely scheduling, provide callers with important information related to their appointment (i.e. Prep information for test, directions, order management etc.) 
• Financial Clearance: up to and including verifying patient demographic, insurance information and securing payment of patients financial liability/performing collection efforts
• If assigned to Order Management:  verifies order is complete and matches scheduled procedure. Includes indexing and exporting physicians orders to correct account number.

If assigned to complex Pre-Reg:

• Collect and verify required patient demographic and financial data elements, including determining a patient’s financial responsibility and securing pre-payment for future services/performing collection efforts 
• Create a complete pre-registration account for an upcoming inpatient/surgical admission
• Completes all pre-certification requirements by obtaining authorization from insurer and/or healthcare facility
• Other duties as assigned based on departmental needs

KNOWLEDGE, SKILLS, ABILITIES

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Ability to work in a production driven call-center environment
• Familiarity with working with dual computer monitors (may be required to use dual monitors)
• Must have basic typing ability
• Must have working knowledge of Windows based computer environment
• Ability to multitask in multiple systems (financial clearance and scheduling) simultaneously
• Extensive multitasking ability
• Strong written and verbal communication skills

Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment.  This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings.

EDUCATION / EXPERIENCE

Include minimum education, technical training, and/or experience preferred to perform the job.

• Required:  High school diploma or GED
• Preferred: Two plus years of college (two years in a professional, customer service-driven environment may substitute for two years of college), completion of related medical certification program
• Preferred:  Telephone/call center experience
• Preferred:  Pre-registration and/or scheduling experience
• Preferred:  2-3 years of customer service experience

PHYSICAL DEMANDS 

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.             

• Must be able to work in sitting position, use computer and answer telephone
• Ability to travel

WORK ENVIRONMENT 

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 

• Office Work Environment
• Hospital Work Environment

TRAVEL

• Approximately 0% travel may be required

As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities, and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step!

Compensation and Benefit Information

Compensation

• Pay: $15.80 - $23.70 per hour. Compensation depends on location, qualifications, and experience. 
• Position may be eligible for a signing bonus for qualified new hires, subject to employment status.
• Conifer observed holidays receive time and a half.

Benefits

Conifer offers the following benefits, subject to employment status:

• Medical, dental, vision, disability, and life insurance
• Paid time off (vacation & sick leave) – min of 12 days per year, accrue at a rate of approximately 1.84 hours per 40 hours worked.
• 401k with up to 6% employer match
• 10 paid holidays per year
• Health savings accounts, healthcare & dependent flexible spending accounts
• Employee Assistance program, Employee discount program
• Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance.
• For Colorado employees, Conifer offers paid leave in accordance with Colorado’s Healthy Families and Workplaces Act.