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Hennepin Healthcare

Pre-Registration Rep Sr

Posted 9 days ago
2-5 years experience
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AI Summary

The specialist confirms patient demographic and insurance information to ensure accurate billing and benefit eligibility. They also manage prior authorizations, provide price estimates, and assist patients with financial counseling resources.

JOB DETAILS
Department: Financial Securing
FTE: 1.00 (80 hours per pay period)
Workdays: Monday - Friday
Shift(s): Days
Shift Length: 8 hours
Location: Remote
*Current List of non-MN States where Hennepin Healthcare is an Eligible Employer: Alabama, Arizona, Arkansas, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Louisiana, Mississippi, Nevada, North Carolina, North Dakota, New Mexico, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin. 

Purpose of this position: The pre-registration specialist confirms all patient demographic information is current and complete, verifies insurance information, and confirms insurance benefit eligibility. The pre-registration process contributes to reduced patient wait times, improved patient satisfaction, and reduced denials stemming from front-end activities

RESPONSIBILITIES

  • Performs pre-registration by contacting the patient via phone and completing an accurate interview to obtain/verify demographics, insurance, medical, and financial information
  • Utilizes Benefit Collection tool to provide patient with estimate of out of pocket expenses for services prior to date of service and attempts to collect any out of pocket expenses
  • Adheres to department policies and procedures related to verification of eligibility/benefits, pre-authorization requirements, and available payment options
  • Identifies patients who may need Advance Beneficiary Notices for Non-covered services (ABN)
  • Refers patients to the Price Estimate Team, as necessary 
  • Connects uninsured/underinsured patients with Financial Counseling or Medicaid eligibility vendor as appropriate
  • Determines whether a service requires a prior authorization. If so, documents appropriately and sends to prior authorization team
  • Creates HARs and sets up appropriate Guarantor
  • Contacts the patient to complete Medicare Secondary Payer Questionnaire for Medicare beneficiaries
  • Thoroughly documents all conversations with patients and insurance representatives
  • Ensures patients have logistical information necessary to receive their service (appointment, place and time, directions to facility)
  • Maintains productivity and quality standards and assists other team members where necessary
  • Other duties as assigned


QUALIFICATIONS
Minimum Qualifications:

  • 2 years clerical experience in health care revenue cycle operations: billing/claims, patient accounting, collections, admissions, registration, etc.
  • Bilingual strongly preferred, required in some positions 

-OR-

  • An approved equivalent combination of education and experience

Preferred Qualifications:

  • Experience working in EPIC, preferred

Knowledge/ Skills/ Abilities:

  • Requires knowledge of government and commercial payer (Insurance) benefit and eligibility verification and ability to become aware of and navigate medical policy per payer guidelines
  • Demonstrated expertise in logical thinking, data preparation, and analysis
  • Comprehensive knowledge of Microsoft Office (Outlook, Word, Excel)
  • Strong communication skills, both verbal and written
  • Ability to communicate effectively with collaborating departments, providers and insurance representatives
  • Demonstrated organizational skills and the ability to prioritize and manage tasks based on established criteria
  • Excellent verbal and written communication and interpersonal skills
  • Ability to work independently with minimal supervision, within a team setting and be supportive of team members
  • Proficient with Microsoft Office
  • Ability to analyze issues and make judgments about appropriate steps toward solutions

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