Insight Hospital and Medical Center
Pre-Certification Specialist
Insight Hospital and Medical Center, Chicago, Illinois, United States, 60290
WE ARE INSIGHT:At Insight Hospital and Medical Center Chicago, we believe there is a better way to provide quality healthcare while achieving health equity. Our Chicago location looks forward to working closely with our neighbors and residents, to build a full-service community hospital in the Bronzeville area of Chicago, creating a comprehensive plan to increase services and meet community needs. With a growing team that is dedicated to delivering world-class service to everyone we meet, it is our mission to deliver the most compassionate, loving, expert, and impactful care in the world to our patients. Be a part of the Insight Chicago team that provides PATIENT CARE SECOND TO NONE! If you would like to be a part of our future team, please apply now!General Summary:
The Pre-Certification Specialist is responsible for processing referrals for services and obtaining needed authorizations from the patient’s payor source. This is to be done for both out-patient testing, out-patient surgeries, and inpatient stays. A Pre-Certification Specialist is responsible for collecting all information needed, to properly notify and obtain authorizations from all of the patient’s payor sources and be able to effectively communicate.These duties are to be performed in a highly confidential manner, in accordance with the mission, values, and behaviors of Mercy Hospital and Medical Center. Employees are further expected to provide a high quality of care, service, and kindness toward all patients, staff, physicians, volunteers, and guests.Duties and Responsibilities:
Contacts insurance companies and other payors to notify of admissionsObtains and clarifies procedural and diagnosis information from physicianIdentifies correct insurance plan and contacts the patient to determine if secondary insurance coverage exists.Receives and processes requests for internal transfers for confirmation of patient benefits and notification of patient status changeVerifies insurance coverage and benefits for patient admissions either electronically or via other mediaMakes written and/or verbal inquiries to third party payers to verify insurance status and obtain pre-certificationRefers patients to financial counselors to assist with payment for servicesCreates patient pre-registration accounts in the electronic system to allow for the addition of notes to an accountKeeps orderly files of information that is gatheredDistributes information to appropriate departments to expedite patient carePerforms various clerical tasks to expedite the verification process, including documentation of guarantor information, patient information, and protocolsAnalyzes reports to determine changes in patient typesPerforms other duties as assignedRequired Knowledge, Skills, and Abilities:
High School Diploma requiredMust have 2 years of college in general business field or technical school related to medical field or experience equivalent to the aboveMust have previous customer service experience or educationAbility to provide excellent customer service at all timesAbility to multi-taskUnderstands medical terminologyUnderstands insurance terminologyUnderstands Medicare, Medicaid, and commercial insurancePrevious experience with data entry computer systemAbility to be organized and systematicInsight Employees are required to be vaccinated for COVID-19 as a condition of employment, subject to accommodation for medical or sincerely held religious beliefs.Insight is an equal opportunity employer and values workplace diversity!
#J-18808-Ljbffr
The Pre-Certification Specialist is responsible for processing referrals for services and obtaining needed authorizations from the patient’s payor source. This is to be done for both out-patient testing, out-patient surgeries, and inpatient stays. A Pre-Certification Specialist is responsible for collecting all information needed, to properly notify and obtain authorizations from all of the patient’s payor sources and be able to effectively communicate.These duties are to be performed in a highly confidential manner, in accordance with the mission, values, and behaviors of Mercy Hospital and Medical Center. Employees are further expected to provide a high quality of care, service, and kindness toward all patients, staff, physicians, volunteers, and guests.Duties and Responsibilities:
Contacts insurance companies and other payors to notify of admissionsObtains and clarifies procedural and diagnosis information from physicianIdentifies correct insurance plan and contacts the patient to determine if secondary insurance coverage exists.Receives and processes requests for internal transfers for confirmation of patient benefits and notification of patient status changeVerifies insurance coverage and benefits for patient admissions either electronically or via other mediaMakes written and/or verbal inquiries to third party payers to verify insurance status and obtain pre-certificationRefers patients to financial counselors to assist with payment for servicesCreates patient pre-registration accounts in the electronic system to allow for the addition of notes to an accountKeeps orderly files of information that is gatheredDistributes information to appropriate departments to expedite patient carePerforms various clerical tasks to expedite the verification process, including documentation of guarantor information, patient information, and protocolsAnalyzes reports to determine changes in patient typesPerforms other duties as assignedRequired Knowledge, Skills, and Abilities:
High School Diploma requiredMust have 2 years of college in general business field or technical school related to medical field or experience equivalent to the aboveMust have previous customer service experience or educationAbility to provide excellent customer service at all timesAbility to multi-taskUnderstands medical terminologyUnderstands insurance terminologyUnderstands Medicare, Medicaid, and commercial insurancePrevious experience with data entry computer systemAbility to be organized and systematicInsight Employees are required to be vaccinated for COVID-19 as a condition of employment, subject to accommodation for medical or sincerely held religious beliefs.Insight is an equal opportunity employer and values workplace diversity!
#J-18808-Ljbffr