Position Details

Department: CORP | Pre Access Services
Category: Patient Access
Location: Telecommuting
Posting #: 547055
Date Posted: 1/26/2021
Employee Type: PRN

Position Summary

Posting Note: This position will work as needed approximately 2 - 3 days per week.

The Pre Access Specialist II is responsible for accurate and complete insurance verification, authorization, and complete pre-registration of all scheduled Diagnostic, Surgical, Audiology and/or Rehabilitation visits. The position works within the EMR using an automated insurance verification tool along with payer websites and documents within the EMR.

PCH Values

  • Family-Centered care that focuses on the need of the child first and values the family as an important member of the care team
  • Excellence in clinical care, service and communication
  • Collaborative within our institution and with others who share our mission and goals
  • Leadership that set the standard for pediatric health care today and innovations of the future
  • Accountability to our patients, community and each other for providing the best in the most cost-effective way.

Position Duties

  1. Obtains insurance verification and benefits using an automated verification tool, insurance carrier websites, or by phone. Prepares an estimate for scheduled service and notifies the patient/guarantor of any applicable out of pocket and requests payment if applicable. Accurately documents all information in the appropriate fields and or/account notes.
  2. Obtains all necessary authorizations for Diagnostic, Surgical, Audiology and/or Rehabilitation visits and accurately documents all information in the appropriate fields and/or account notes.
  3. Organizes, prioritizes and reviews daily work activity to ensure completion of assigned workload.
  4. Courteously answers telephone and/or emails and answers all questions in a timely manner. Maintains a positive working relationship with patients/guarantors, insurance companies, clinical personnel, co workers, and management to promote teamwork, cooperation, and a positive public image for PCH.
  5. Participates in a variety of unit and hospital educational programs to maintain current skill and competency levels.
  6. Performs miscellaneous job related duties as requested.

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Position Qualifications

Please review the following qualifications and specify whether you meet each of the requirements listed.
Do you meet this requirement?
1. Associates in Business or related field or combination of education and experience. Required
Do you meet this requirement?
1. Experience with EMR, document management/imaging system, or Payer websites platform. Required
2. 1 Year experience requesting Professional/Clinic or Hospital Authorizations Required
3. Experience reviewing and discussing out of pocket liability to patients/guarantors. Required
4. Minimum of one year customer service experience Required
5. Knowledge base and experience with CPT codes, J Codes, and ICD Codes. Required
6. Minimum of one year of medical registration or scheduling experience. Preferred
Do you meet this requirement?
Special Skills
1. 1.Must be able to work independently and ability to work effectively in a high-volume, fast paced environment with changing priorities. Must possess customer-focused attitude and professional demeanor. Required
2. 2.Excellent communication skills (Written and Oral). Required
3. 3.Knowledge of Medical Terminology and an understanding of HIPAA Privacy Laws. Required
4. 4.Analytical skills with strong attention to detail and a high degree of accuracy. Required
5. 5.Proficiency with computer based systems. Required
6. 6. Bilingual (Spanish) Preferred
Physical Requirements & Occupational Exposure/Risk Potential
1. Physical Requirement - Climbing Occasionally
2. Physical Requirement - Feeling (sensing textures and temperatures) Occasionally
3. Physical Requirement - Fine Motor Skills (pinching, gripping, etc) Frequently
4. Physical Requirement - Hearing Frequently
5. Physical Requirement - Pushing/pulling Occasionally
6. Physical Requirement - Reaching Occasionally
7. Physical Requirement - Sitting Constantly
8. Physical Requirement - Standing Occasionally
9. Physical Requirement - Stooping/crouching/kneeling/crawling Occasionally
10. Physical Requirement - Talking Constantly
11. Physical Requirement - Tasting/smelling Occasionally
12. Physical Requirement - Walking Occasionally
13. Physical Requirement - Near Vision Frequently
14. Physical Requirement - Far Vision Frequently
15. Physical Requirement - Color Discrimination Occasionally
16. Physical Requirement - Use of keyboard, mouse and/or computer equipment Constantly
17. Physical Requirement - Lift up to 35 pounds without assistance Occasionally
18. Physical Requirement - Lift more than 35 pounds without assistance Occasionally
I have reviewed the qualifications, physical requirements and occupational exposure/risk potential for this position and wish to apply