Pre-Service Center Verification Specialist

🔥 0 minutes ago

🍂 Massachusetts – Remote

🍂 Massachusetts – Remote

💵 $24 - $29 / hour

⏰ Full Time

🟢 Junior

🚫👨‍🎓 No degree required

👻 Ghost score 0%

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Boston Medical Center (BMC)

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

Founded 1996

Boston Medical Center (BMC) is a 511-bed, equity-led academic medical center and a proud member of the Boston Medical Center Health System. BMC delivers a model of healthcare where innovative and equitable care empowers all patients to thrive. As a premier academic medical center in Boston, a national leader in clinical care, and the largest essential hospital in New England, BMC’s world-class clinicians provide comprehensive care in more than 70 specialties and subspecialties.

📋 Description

• Coordinate financial clearance activities across pre-registration, insurance verification, referrals, prior authorizations, precertifications, and pre-service cash collections • Monitor registration, referral, and prior authorization work queues and obtain required patient and payer-specific clearance elements • Navigate BMC and payer policies to secure approvals and support patient access to services • Assist BMC staff with financial clearance issues • Obtain, document, and link referrals and prior authorizations in Epic and relevant practice management systems • Collaborate with practices, physicians, insurance carriers, patients, case management, Patient Financial Counseling, and other departments • Resolve registration, insurance verification, referral, and authorization issues; escalate denied or uncleared accounts • Interview patients, families, and referring physicians to obtain demographic, financial, insurance, and reimbursement information • Create new registration records and maintain accurate demographic and insurance information • Process copayments, coinsurance, deductibles, and outstanding patient balances • Maintain confidentiality and comply with HIPAA, legal, regulatory, infection control, and safety requirements • Handle telephone calls according to scripting and customer service standards • Participate in quality audits, training, process improvement, and educational opportunities • Meet productivity and quality expectations and perform other assigned duties • Contact IT Help Desk or appropriate vendors regarding faulty systems or equipment

🎯 Requirements

• High School Diploma or GED required • 1–3 years of hospital registration and/or insurance experience desirable • At least one year of experience in a customer service role • General knowledge of healthcare terminology and CPT-ICD10 codes • Complete understanding of insurance preferred • Demonstrated customer service skills and ability to use judgment, independent thinking, and creativity when resolving customer issues • Exceptional interpersonal skills • Effective written and verbal communication skills • Ability to work in a complex environment with varying points of view • Good decision-making and judgment capabilities; attention to detail • Knowledge of and experience within Epic preferred • Technical proficiency within Epic workqueues and ancillary systems, including ADT/Prelude/Grand Centrale • Strict confidentiality of personal and health-sensitive information • Ability to handle challenging situations and balance multiple priorities • Basic computer proficiency, including Microsoft Excel, Word, Outlook, and Zoom • Knowledge of Revenue Cycle processes and ability to meet productivity standards • Ability to attend required hospital and department training • Must adhere to BMC’s RESPECT behavioral standards

🏖️ Benefits

• Medical, dental, vision, and pharmacy benefits • Contract increases • Flexible Spending Accounts • 403(b) savings matches • Earned time cash out • Paid time off • Career advancement opportunities • Resources to support employee and family wellbeing • Educational offerings and development opportunities • Remote work