Pre-Service Center Verification Specialist

🔥 17 hours ago

🇺🇸 United States – 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 through pre-registration, patient demographic and insurance validation, insurance verification, referral authorization, precertification, and pre-service cash collections • Monitor registration, referral, and prior authorization work queues and obtain required financial clearance elements • Navigate BMC and payer policies to secure approvals, authorizations, precertifications, and referrals • Support BMC staff with financial clearance issues • Obtain insurance verification, authorizations, and referrals using online databases, electronic correspondence, faxes, and phone calls • Document referrals and prior authorizations in Epic and practice management systems • Collaborate with practices, physicians, insurance carriers, patients, and departments to resolve registration, insurance, referral, and authorization issues • Follow up on management reports and work queues and escalate denied or uncleared accounts • Interview patients, families, and referring physicians to obtain financial, demographic, and insurance information • Create new patient registration records and update demographic and insurance information • Process copayments, coinsurance, deductibles, and outstanding patient balances • Maintain confidentiality and advise management of compliance issues • Participate in education, process improvement, quality audits, and revenue cycle collaboration • Meet productivity and quality standards and handle telephone calls according to customer service standards

🎯 Requirements

• High School Diploma or GED required • 1-3 years 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 • Knowledge of insurance • Demonstrated customer service skills • Exceptional interpersonal skills • Effective written and verbal communication skills • Decision-making, judgment, and 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/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 • Must comply with healthcare collection laws and confidentiality policies

🏖️ 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 other development opportunities • Fully remote work arrangement • No requirement to purchase equipment for or prior to employment