[Hiring] Senior Pre-Registration Representative @Hennepin Healthcare

Role Description

The pre-registration specialist confirms all patient demographic information is current and complete, verifies insurance information, and confirms insurance benefit eligibility. The pre-registration process contributes to reduced patient wait times, improved patient satisfaction, and reduced denials stemming from front-end activities.

• Performs pre-registration by contacting the patient via phone and completing an accurate interview to obtain/verify demographics, insurance, medical, and financial information.
• Utilizes Benefit Collection tool to provide patient with estimate of out of pocket expenses for services prior to date of service and attempts to collect any out of pocket expenses.
• Adheres to department policies and procedures related to verification of eligibility/benefits, pre-authorization requirements, and available payment options.
• Identifies patients who may need Advance Beneficiary Notices for Non-covered services (ABN).
• Refers patients to the Price Estimate Team, as necessary.
• Connects uninsured/underinsured patients with Financial Counseling or Medicaid eligibility vendor as appropriate.
• Determines whether a service requires a prior authorization. If so, documents appropriately and sends to prior authorization team.
• Creates HARs and sets up appropriate Guarantor.
• Contacts the patient to complete Medicare Secondary Payer Questionnaire for Medicare beneficiaries.
• Thoroughly documents all conversations with patients and insurance representatives.
• Ensures patients have logistical information necessary to receive their service (appointment, place and time, directions to facility).
• Maintains productivity and quality standards and assists other team members where necessary.
• Other duties as assigned.

Qualifications

• Minimum Qualifications:
• 2 years clerical experience in health care revenue cycle operations: billing/claims, patient accounting, collections, admissions, registration, etc.
• Bilingual strongly preferred, required in some positions.
• -OR-
• An approved equivalent combination of education and experience.
• Preferred Qualifications:
• Experience working in EPIC, preferred.

Requirements

• Requires knowledge of government and commercial payer (Insurance) benefit and eligibility verification and ability to become aware of and navigate medical policy per payer guidelines.
• Demonstrated expertise in logical thinking, data preparation, and analysis.
• Comprehensive knowledge of Microsoft Office (Outlook, Word, Excel).
• Strong communication skills, both verbal and written.
• Ability to communicate effectively with collaborating departments, providers and insurance representatives.
• Demonstrated organizational skills and the ability to prioritize and manage tasks based on established criteria.
• Excellent verbal and written communication and interpersonal skills.
• Ability to work independently with minimal supervision, within a team setting and be supportive of team members.
• Proficient with Microsoft Office.
• Ability to analyze issues and make judgments about appropriate steps toward solutions.