Pre-Service Rep FCC

We've made a lot of progress since opening the doors in 1942, but one thing has never changed - our commitment to serve, heal, lead, educate, and innovate. We believe that every award earned, every record broken and every patient helped is because of the dedicated employees who fill our hallways. At Ochsner, whether you work with patients every day or support those who do, you are making a difference and that matters. Come make a difference at Ochsner Health and discover your future today! This job is responsible for assisting patients by communicating with insurance payors via various methods (i.e. telephone, fax, internet) to determine eligible benefits and acquiring Pre-Certification(s) when deemed necessary by the insurance payor. Additionally responsible for communicating the liability to the patient after the Pre-Certification has been obtained and ensuring the Pre-Service process has been completed in advance of the patient’s arrival for scheduled service(s). To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential duties. This job description is a summary of the primary duties and responsibilities of the job and position. It is not intended to be a comprehensive or all-inclusive listing of duties and responsibilities. Contents are subject to change at the company's discretion. Education Required – High School diploma or equivalent Preferred – Associates Degree or Bachelor Degree Work Experience Required – 1 year related experience inf related hospital, clinic, medical office, business services/revenue cycle, front line registration, financial counseling, banking and/or customer service related job Preferred – Experience with of EPIC Knowledge Skills and Abilities (KSAs) Must have computer skills and dexterity required for data entry and retrieval of patient information. Effective verbal and written communication skills and the ability to present information clearly and professionally to varying levels of individuals throughout the patient care process. Must be proficient with Windows-style applications, keyboard, and various software packages specific to role. Strong interpersonal skills. Ability to multi-task. Ability to perform effectively in a fast paced ever changing environment. Ability to remain calm and professional in high pressure/stressful situations regarding patient financial and medical conversations. Reliable transportation to travel to other facilities to fill in as needed. Job Duties Prepares, validates and completes all steps necessary to clear new cases for pre-scheduled services. This includes, but is not limited, to validating and gathering insurance and demographic information. Interacts with insurance companies via, website, phone, or fax to verify benefits, obtain authorizations, identify insurance guidelines, and facilitate communication. Gathers information to verify benefits and benefits eligibility by s utilizing the EPIC system. Completes and obtains all necessary authorizations for the service(s) to be performed. Works with the clinical providers , on- site case management team, as well as LPN/RN or Nurse Auditor in the Pre-Service department. Performs Pre-Service collection estimation functions and communicates patient liability. Provides point –of – service information and logistics to ensure an exceptional patient experience. Other related duties as required. The above statements describe the general nature and level of work only. They are not an exhaustive list of all required responsibilities, duties, and skills. Other duties may be added, or this description amended at any time. Remains knowledgeable on current federal, state and local laws, accreditation standards or regulatory agency requirements that apply to the assigned area of responsibility and ensures compliance with all such laws, regulations and standards. This employer maintains and complies with its Compliance & Privacy Program and Standards of Conduct, including the immediate reporting of any known or suspected unethical or questionable behaviors or conduct; patient/employee safety, patient privacy, and/or other compliance-related concerns. The employer is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or disability status. Physical and Environmental Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Light Work - Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly (Constantly: activity or condition exists 2/3 or more of the time) to move objects. Physical demand requirements are in excess of those for Sedentary Work. Even though the weight lifted may be only a negligible amount, a job should be rated Light Work: (1) when it requires walking or standing to a significant degree; or (2) when it requires sitting most of the time but entails pushing and/or pulling of arm or leg controls; and/or (3) when the job requires working at a production rate pace entailing the constant pushing and/or pulling of materials even though the weight of those materials is negligible. NOTE: The constant stress and strain of maintaining a production rate pace, especially in an industrial setting, can be and is physically demanding of a worker even though the amount of force exerted is negligible. Normal routine involves no exposure to blood, body fluid or tissue and as part of their employment, incumbents are not called upon to perform or assist in emergency care or first aid. The incumbent has no occupational risk for exposure to communicable diseases. Because the incumbent works within a healthcare setting, there may be occupational risk for exposure to hazardous medications or hazardous waste within the environment through receipt, transport, storage, preparation, dispensing, administration, cleaning and/or disposal of contaminated waste. The risk level of exposure may increase depending on the essential job duties of the role. Are you ready to make a difference? Apply Today! Ochsner Health does not consider an individual an applicant until they have formally applied to the open position on this careers website. Individuals who reside in and will work from the following areas are not eligible for remote work position: Colorado, California, Washington, and New York. Ochsner Health endeavors to make our site accessible to all users. If you would like to contact us regarding the accessibility of our website, or if you need an accommodation to complete the application process, please contact our HR Employee Solution Center at 504-842-4748 (select option 1) or careers@ochsner.org. This contact information is for accommodation requests only and cannot be used to inquire about the status of applications. We are proud to be an Equal Employment Opportunity and Affirmative Action employer. We are committed to the principles of equal employment opportunity and providing a workplace that is free from discrimination based on race, color, creed, religion, pregnancy status, pregnancy-related conditions, national origin, ancestry, mental or physical disability, medical condition, age, veteran status, military status, citizenship status, marital status, familial status, sexual orientation, gender, gender identity or expression, genetic information, political affiliation, unemployment status, or any other characteristic protected under applicable federal, state or local law. These protections extend to applicants and all employment related decisions. View the EEO is the Law poster and its supplement, as well as the pay transparency policy for more information. Affirmative Action Policy Statement Ochsner Health is an integrated healthcare system with a mission to Serve, Heal, Lead, Educate and Innovate. Celebrating 80 years in 2022, it leads nationally in cancer care, cardiology, neurosciences, liver and heart transplants and pediatrics, among other areas. Ochsner is consistently named both the top hospital and top children’s hospital in Louisiana by U.S. News & World Report. The not-for-profit organization is inspiring healthier lives and stronger communities. Its focus is on preventing diseases and providing patient-centered care that is accessible, affordable, convenient and effective. Ochsner Health pioneers new treatments, deploys emerging technologies and performs groundbreaking research, including over 700 clinical studies. It has more than 36,000 employees and over 4,600 employed and affiliated physicians in over 90 medical specialties and subspecialties. It operates 47 hospitals and more than 370 health and urgent care centers across Louisiana, Mississippi, Alabama and the Gulf South; and its cutting-edge Connected Health digital medicine program is caring for patients beyond its walls. In 2021, Ochsner Health treated more than 1 million people from every state and 75 countries. As Louisiana’s top healthcare educator, Ochsner Health and its partners educate thousands of healthcare professionals annually. To learn more, visit www.ochsner.org. Ochsner Health is Proud to be an Employer of Choice. Recognized by Zippia as one of the “20 Best Companies to Work for in New Orleans, LA” Named as a 2020 Top Workplace by Times-Picayune Named one of the 2021 Top Workplaces in the USA by Energage Named to the Forbes list of America’s Best Employers for Veterans 2020 Named to the Becker’s Healthcare 2020 list of “100 Great Hospitals in America” Named to the Becker’s Healthcare 2020 list of "52 Great Health Systems to Know" Opportunities listed here represent open positions at Ochsner Health and Ochsner Health managed entities.