Responsible for performing financial clearance (insurance eligibility, benefit verification, authorization (non-clinical), and pre-service financial counseling) activities in the Revenue Cycle Outpatient Services Center, including communication with patients and insurance companies for the purpose of collecting information necessary to clear patients, notification of the status of their scheduled outpatient visits, pertinent information regarding their benefits, as well as collection of any patient liabilities.
Verifies patient insurance eligibility and benefits using technology tools, the telephone and the Internet
Communicates with Patients/Guarantors to advise them of the status of their upcoming outpatient visits; advise them of the status of their benefits; to explain their financial responsibilities in an attempt to collect patient liabilities; and to obtain any missing information necessary to achieve financial clearance.
Works closely with the Facility business office staff to assist in the identification and collection of patient liabilities. Identifies accurate patient portions in order to collect the money pre-visit.
Coordinates with insurance providers and departments to obtain referrals and pre-authorizations. Documents these findings into the appropriate system(s).
Verifies medical necessity and coordinates with Clinicians to obtain updated information.
Enters appropriate documentation into the respective system resulting in proper transmission of necessary information back to the facility for processing when the patient presents at the facility.
Refers all Customer quality of care and complaint issues to immediate Supervisor - also any issues that the Rep deems to be out of his or her control.
Participates in cross-training to provide support to team members performing other revenue cycle functions as needed.
High School Diploma or equivalent
2 -5 years administrative experience in medical facility (outpatient healthcare provider a plus), health insurance, or related area
2-5 years experience in Customer Service or related call center environment
Experience with AdvantX application preferred
Excellent verbal and written communication skills
Intermediate level skills in 10-key calculator by touch
Intermediate level skills in the use of general office equipment (fax, copier and computers)
Intermediate data entry and typing skills (30 WPM minimum)
Ability to interpret third party payor principlels and terms
Ability to resolve problems and analyze data
Ability to communicate effectively with patients, team members and management
Ability to work within a team setting and be supportive of team members
Ability to work successfully in a fast paced environment with frequent interruptions
Multilingual a plus
Maintains minimum productivity goals set forth by department
Job: Conifer Health Solutions
Primary Location: Des Moines, Iowa
Job Type: Full-time
Shift Type: Days
Employment practices will not be influenced or affected by an applicantâ��s or employeeâ��s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.
Internal Number: 1905030868
About Conifer Health Solutions
“Tenet Healthcare Corporation is a diversified healthcare services company with 115,000 employees united around a common mission: to help people live happier, healthier lives. Through its subsidiaries, partnerships and joint ventures, including United Surgical Partners International, the Company operates general acute care and specialty hospitals, ambulatory surgery centers, urgent care centers and other outpatient facilities. Tenet's Conifer Health Solutions subsidiary provides technology-enabled performance improvement and health management solutions to hospitals, health systems, integrated delivery networks, physician groups, self-insured organizations and health plans.