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Murfreesboro, Tennessee, United States
Hybrid
At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience.
Summary:
Determines and verifies insurance coverage and coordination of insurance benefits from all sources. Requests and/or verifies authorizations for ordered services. Schedule and/or reschedule physician orders for outpatient treatments and/or diagnostic services. Discuss financial responsibilities for upcoming appointments with patient and/or guarantor. Collect upfront payments and/or review for financial assistance. Handles inbound and/or outbound calls related to the above functions.Responsibilities:
Confirms insurance coverage. Determines necessity for pre-authorization and obtains authorization for that service(s). Documents authorization information within the patient account.Updates patient insurance information into the patient record as needed to ensure correct billing and net revenue estimation occurs.Reviews order for appropriate authorizing signature and accuracy of scheduled service(s).Communicates with patients and practitioners regarding order, insurance and/or authorization issues.Notifies patient of their financial responsibility for services to be provided. Educates guarantor about their out of pocket responsibility for the service and collects pre-service payments in accordance with available financial options. Ensures compliance with departmental procedures for payment. Document details of the call and notate any collections that need to be performed at time of registration.Handles inbound and/or outbound calls to perform all pre-service functions included but not limited to scheduling, authorizations, benefits, and patient responsibilities. Documents appropriate record with the details of the call and the call disposition.Inputs and/or reviews insurance benefits for the patient account. Re-runs estimates when needed to correct expected patient out of pocket liability for that service.Competencies:
ACCOUNTABILITY, ACCURACY, CUSTOMER SERVICE, ORGANIZATION SKILLS, PROBLEM SOLVING, PRODUCTIVITY, RESPONDING TO CHANGE, STANDARDS OF BEHAVIOREducation and Certification Requirements:
High School Diploma or Equivalent (Required)Additional Job Information:
Complexity of Work: Requires excellent communication skills, critical thinking skills, decisive judgment and the ability to work with minimal supervision. Must be able to work in a stressful environment and take appropriate action. Required Work Experience: No prior experience required. Other Information: Preferred experience with hospital authorizations and health insurance knowledge.Working Conditions and Physical Requirements:
Shift:
Primarily for office workers - not eligible for shift differentialDisclaimer: This job description is not intended, nor should it be construed to be an exhaustive list of all responsibilities, skills, efforts or working conditions associated with the job. It is intended to indicate the general nature and level of work performed by employees within this classification.
Wages shown on independent job boards reflect market averages, not specific to any employer. We encourage candidates to talk to their Memorial Healthcare System recruiter to discuss actual pay rates, during the hiring process.
Memorial Healthcare System is proud to be an equal opportunity employer committed to workplace diversity.
Memorial Healthcare System recruits, hires and promotes qualified candidates for employment opportunities without regard to race, color, age, religion, gender, sexual orientation, national origin, veteran status, disability, genetic information, or any factor prohibited by law.
We are proud to offer Veteran’s Preference to former military, reservists and military spouses (including widows and widowers). You must indicate your status on your application to take advantage of this program.
Employment is subject to post offer, pre-placement assessment, including drug testing.
If you need reasonable accommodation during the application process, please call 954-276-8340 (M-F, 8am-5pm) or email TalentAcquisitionCenter@mhs.net
