Pre-Registration Representative Senior

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