Qualifications
Location:
220 Popps Ferry Rd Biloxi, MS 39532
Job Summary:
The Precertification Specialist I is responsible for verifying patient demographics and insurance benefits, assuring authorizations for service are in place, and informing patient of estimated payment amount.
The Specialist maintains a resource schedule and acts as a liaison with the patient, provider, physician and insurance companies.
Job Description:
Ensures completeness and integrity of patient registration
Verifies and documents patient demographics, guarantors, and insurance information
Validates correct insurance at the time of registration and maintains a 4% or less error rate
Completes the pre-admission processes specific to assignment
Monitors schedules of assigned areas for added tests or procedures
Performs financial processes and communicates patient's responsibility
Creates estimates of charges based on available information and collects pre-payments when necessary
Communicates financial options to patients prior to testing with possible referral to Financial Counselors
Screens testing urgency based on patient’s ability to pay
Balances cash sheets and audits
Assures the MHG financial policy qualifications are met
Monitors authorization status and alerts Provider Staff or Precertification Specialist II if not received at least 3 days prior to date of service
Obtains copies of authorizations for non-MHG providers to receive reimbursement for MHG
Communicates with provider to modify testing/procedure orders to a medically necessary diagnosis based on payer guidelines
Required Qualifications:
Education: High School Diploma or GED equivalent.
Experience: One (1) year of previous clerical experience.
Customer Service Agreement
I have read the Customer Service Agreement;for providing excellent customer service and representing Memorial.
About Memorial
Memorial Health System has been dedicated to healing, inspiring, and transforming the health of our community since 1946.
With multiple hospital facilities, outpatient surgery locations and diagnostic centers, more than 100 Physician Clinics, and post-acute services including skilled nursing, you can find your fit at Memorial.
When you join our team, you join more than 5,000 individuals committed to exceptional care.
We offer several of the region's most comprehensive clinical programs and medical specialties unique to the Coast, including a Level III Neonatal ICU, state-designated Level II Trauma Center, Hyperbaric Oxygen Therapy, and Mississippi's first nationally-certified Primary Stroke Center.
At Memorial, you are valued.
We know that our increasingly diverse communities need healthcare professionals that reflect their different cultural backgrounds, perspectives, and values.
We acknowledge the uniqueness of all individuals, their commonalities as well as differences, all of which have shaped their lives in meaningful ways.
The development of our team members is integral to the patient care we provide.
Grow your skills, and grow with Memorial.
Memorial Health System is an equal opportunity employer and does not discriminate on the basis of any legally protected status or characteristic.
Minority/Female/Sexual Orientation/Gender Identity/Disability/Veteran.
Whatsapp
