Preservice & Insurance Verification Specialist | Allentown, PA

Detailed Information

  • Location: Allentown, PA

  • Company: Lehigh Valley Health Network

Communicates new insurance benefits found to Utilization Management as well as other departments and physician offices throughout the network. Job Duties Obtains and verifies demographic, clinical, financial, and insurance information in the process of pre-registering and financially clearing patients for service delivery.

Performs complete and accurate account pre-registration and insurance verification functions. Meets required accuracy rates. Completes registrations in accordance with department productivity and timeliness standards. Works to provide patient information which maximizes reimbursement, achieves collection ratios, and meets accounts receivable (AR) goals. Ensures that

scheduled appointments match the corresponding account status registration so that information flows into the designated work queue workflows. Creates estimates and identifies any non-covered patient responsibilitiy such as coinsurance, deductibles, and copayments prior to service.

Provides general information to hospital departments, physician offices, patients, and families and ensures that patients meet financial requirements. Works with all pre-service departments and any department throughout the revenue cycle to ensure patient expectations are met. Minimum Qualifications High School Diploma/GED 3 years Previous experience in a customer-oriented environment, patient registration,

or insurance-related field. and 1 year Experience in a related healthcare environment with pre-cert, billing, and registration background.

Ability to anticipate and understand customer financial needs, document, and/or relay patients' needs to appropriate personnel. Knowledge of medical terminology. Must be self directed and able to prioritize duties in fast paced environment. Preferred Qualifications Associate's Degree and Specialized training in insurance, coding, billing, or similar healthcare certificate programs. Knowledge of EPIC, Navinet, and Passport. Ability to speak Spanish. Physical Demands Lift and carry 25 lbs. frequent sitting/standing, frequent keyboard use, patient care providers may be required to perform activities specific to their role including kneeling, bending, squatting and performing CPR.

Job Description Disclaimer: This position description provides the major duties/responsibilities, requirements and working conditions for the position. It is intended to be an accurate reflection of the current position, however management reserves the right to revise or change as necessary to meet organizational needs. Other responsibilities may be assigned when circumstances require.

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