Pre-Admission Specialist
DescriptionBecome part of an inclusive organization with over 40,000 diverse employees, whose mission is to improve the health and well-being of the unique communities we serve.Summary:The Pre-Admission Specialist is responsible for assuring appropriate insurance verification, prior approvals, and all authorization requirements are obtained prior to the patient's arrival for surgery, out-patient testing, and during the patient's observation or in- patient hospitalization. Communicates with other departments including registration, billing, scheduling and care management. Responsible for accurately updating patient benefit information in the hospital’s insurance system and verifying that existing information is correct. Makes pre-registration phone calls to pre-register patients for future services and to discuss their financial responsibility.Responsibilities:
Verifies insurance eligibility and coverages for all patients.
Coordinates with physicians’ offices, payors, and patients (as needed) to ensure services are authorized.
Generates, prints, and mails estimates.
Contacts patients to confirm patient information, coverage, and service date as part of the pre-registration process.
Informs patients of their liabilities and attempts to collect payments (i.e. takes payments over the phone, etc.).
Submits notification for IP/OBS urgent admits.
Proactively identifies unauthorized visits and ensures authorization is obtained prior to the date of service.
Abides by the Wayne UNC – Financial Clearance Collections Policy.
Completes Work Queue responsibilities appropriately and timely.
Documents all notes and transactions appropriately.
Meets or exceeds goals pertaining to productivity and quality expectations.
Assists in training teammates from the Pre-Admission team.
Serves a resource and role model for other teammates in the area.
Other information:EducationHigh school diploma or GED required.Associates degree in business or related field preferred.Licensure/CertificationCRCR certification from HFMA within one year of hire.ExperienceMinimum of two (2) years of experience in patient access, registration, billing, insurance and/ or precertification required. Experience with insurance carriers or a third-party administrator is preferred.Bi-lingual is a plus.Knowledge, Skills and Abilities Excellent customer service and interpersonal skills with the ability to work well with the public and co-workers both in person and over the telephone. Ability to work with deadlines and within timelines. Detail oriented and organized. Ability to read, write and communicate effectively in English. Proficient with MS Office and EPIC. Able to learn new software rapidly.Valid NC Driver’s License: NoIf driving a Wayne UNC Vehicle, must be 21 years old and MVR must be approved by Risk Management.BO-21301.8524.BO-213.NON-CLINJob DetailsLegal Employer: Wayne HealthEntity: Wayne UNC Health CareOrganization Unit: AdmittingWork Type: Full TimeStandard Hours Per Week: 40.00Work Assignment Type: OnsiteWork Schedule: Day JobLocation of Job: WAYNE MEDExempt From Overtime: Exempt: NoQualified applicants will be considered without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.