McLaren Health Care PreRegistration Specialist in Detroit, Michigan
Job Summary: Under general supervision, pre-registers
patients and correctly identifies and obtains authorizations if needed prior to
the date of service based on departmental policies and procedures. Contacts PCP/Insurance Company to attempt to
obtain referrals if needed prior to date of service based on insurance
guidelines. Conducts appropriate and timely follow-up with patients, physician
offices and insurance carriers as needed and documents all relevant information
related to the visit in the Capstone system.
Obtains accurate insurance, medical and demographic data. Verifies insurance coverage, benefit levels,
annual life time term and co-pays and co-insurances with various third party
payors. Using the appropriate work list,
completes all job functions assigned daily.
Work closely with the Financial Counselor, and where applicable, inform
the patient of his/her financial responsibility prior to the patient’s visit.
Contacts patients to conductpre-registration using daily work list. Maintains productivity standards setwithin the department. Collects and verifies all information contained withinthe outpatient registration conversation including demographic and insuranceinformation.
Contacts insurance companies toverify insurance coverage, benefit levels, term/max life, co-pays andco-insurances.Responds to third partyinquiries for various account information not normally supplied in the billingprocess. Uses on-line systems when available.
Monitors and secures referrals andauthorization prior to date of services and advises supervisor of anyincomplete accounts. Contacts patients when appropriate to advise them of theirresponsibility to contact the primary care physician to obtain referrals orauthorizations.
Scans and files referrals andauthorizations into IDoc and documents within Capstone.
Establishes and maintains contactswith KCI representatives and physician office staff.
High school diploma required.Two years of college preferred.
Two or more years of previous work experience in insurance, medical records/coding, billing or related area to develop knowledge of healthcare revenue cycle.
Strong communication skills, both written and verbal.
Experience with computers and other office equipment.
Good organizational and analytical ability; must be detail oriented.
Proven customer service skills, along with commitment to patient satisfaction.
Equal Opportunity Employer of Minorities/Females/Disabled/Veterans
Primary Location: Michigan-Detroit-New Center One
Employee Status Regular
Shift Day Job
Job Type Standard
Req ID: 21001119