Pre Service Center Verification Specialist

🔥 0 minutes 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, demographic and insurance validation, insurance verification, referral authorization, precertification, and pre-service cash collection • Monitor registration, referral, and prior authorization work queues and clear them according to management guidelines • Navigate BMC and payer policies to obtain authorizations, precertifications, and referrals • Support BMC staff in understanding and resolving financial clearance issues • Obtain insurance verification, authorizations, and referrals using online databases, electronic correspondence, faxes, and phone calls • Document referral and prior authorization information in Epic and relevant practice management systems • Collaborate with practices, physicians, insurance carriers, patients, case management, Patient Financial Counseling, and other departments • Obtain, validate, and update patient demographic, insurance, eligibility, primary care physician, subscriber, employer, and appointment information • Create new patient registration records and complete required registration data • Process copayments, coinsurance, deductibles, and outstanding patient balances • Refer self-pay or unresolved-insurance patients to Patient Financial Counseling • Escalate denied or financially uncleared accounts according to department policy • Conduct patient, family, and physician interviews by telephone before appointments when possible • Resolve registration, insurance verification, referral, and authorization issues • Maintain confidentiality and comply with healthcare collection laws, HIPAA, and regulatory policies • Meet productivity and quality standards and participate in managed-care quality audits • Handle telephone calls and route issues appropriately • Contact the BMC IT Help Desk or appropriate vendors regarding faulty systems or equipment • Attend required training and participate in process-improvement initiatives • Perform other related duties as assigned

🎯 Requirements

• High School Diploma or GED required • 1-3 years Hospital registration and/or Insurance experience desirable • At least one year of experience must be 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 communication skills • Excellent verbal communication skills • Ability to work in a complex environment with varying points of view • Comfortable with ambiguity, good decision-making and judgment capabilities, and attention to detail • Knowledge of and experience within Epic preferred • Technical proficiency within Epic workqueues and ancillary systems, including ADT/Prelude/Grand Centrale • Ability to maintain strict confidentiality of personal and health-sensitive information • Ability to handle challenging situations and balance multiple priorities • Basic computer proficiency, including computerized data access, entry, and interpretation • Proficiency in Microsoft Suite applications, specifically Excel, Word, Outlook, and Zoom • Thorough knowledge of various work-unit sections to provide assistance and backup coverage • Deep understanding of Revenue Cycle processes • Must adhere to HIPAA, hospital safety and infection control procedures, organizational policies, and BMC 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 sponsored by BMC or other development opportunities • Remote work arrangement • Employer does not require employees to purchase equipment for or prior to employment