What are the responsibilities and job description for the Pre-Services Representative, Full Time, Remote position at Adventist Health Roseville?
Adventist Health is more than an award-winning health system. We provide whole-person care to our communities and champion the greater good - from the operating room to the boardroom, we are driven by our unique passion to live God's love through health, wholeness and hope. From Oregon to Oahu, we have a calling to always do more. Now is your chance to apply your passion to our mission.
We're looking for someone to join our team as a Pre-Services Representative who:
Performs insurance verification and obtains authorizations for services, negotiates and receives patient's payments. Works with patient to collect financial responsibility and assists them with application and documentation process for Medicaid/County Medical Services Program (CMSP). Works on routine assignments within defined parameters, established guidelines and precedents. Follows established procedures and receives daily instructions on work.
Essential Functions:
- Completes patients packets with all necessary forms and documents in preparation for admissions. Coordinates admissions activities in order to obtain all necessary patient information for billing, but also any needed by other departments such as medical records. Discusses, arranges and receives payment of bills with patient or representative for co-payments and private pay accounts.
- Assists customers with Medicaid/County Medical Services Program (CMSP) applications by evaluating documentation for completeness and accuracy, monitoring their compliance with requirements and establishing appointments with county welfare office.
- Maintains and updates patients accounts for medical and financial eligibility. Maintains reports related to case qualifications. Obtains all necessary billing, insurance and other demographic information from patient or representative. Obtains necessary authorizations for inpatient stays from utilization review. Posts payments and corresponding contractual adjustments to patient's accounts. Serves as a resource to public providing insurance information and benefits. Sets up payment schedules if patients or representative are unable to pay balances in full.
- Performs other job-related duties as assigned.
You'll be successful with the following qualifications:
Education:
- High School Education/GED or equivalent: Preferred
- Associate's / Technical Degree or equivalent combination of education/related experience: Preferred
Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations, including, but not limited to, measles, mumps, flu (based on the seasonal availability of the flu vaccine typically during October-March each year), COVID-19 vaccine (required in CA, HI and OR) etc., as a condition of employment, and annually thereafter. Medical and religious exemptions may apply.