Preservice Specialist I - Full Time

Description

Full Time: Monday-Friday 8:30am-5:00pm. Hybrid-Remote.

Northwell is the largest not-for-profit health system in the Northeast, serving residents of New York and Connecticut with 28 hospitals, more than 1,000 outpatient facilities, 22,000 nurses and over 20,000 physicians. Northwell cares for more than three million people annually in the New York metro area, including Long Island, the Hudson Valley, Connecticut and beyond, thanks to philanthropic support from our communities. Northwell is New York State’s largest private employer with over 104,000 employees — including members of Northwell Health Physician Partners — who are working to change health care for the better.

Summary:

Facilitates patient flow through the referral, scheduling, and financial clearance process. Responsible for obtaining demographic and financial information to ensure accurate patient identification and to secure reimbursement. Performs pre-registration functions and insurance eligibility verification. Provides estimates for services. Requests and secures payments.

Responsibilities:

1.May be assigned to schedule patients for hospital or medical group services by incoming phone calls, online requests, or outbound to patients. 2.May be assigned to work within the central referral management system to identify and schedule specialist and primary care referrals to NHMP practices as well as external providers when appropriate, with the goal of promoting in-system retention of patients and continuity of care. 3.Provides excellent customer service both to physician offices and patients. Contributes to reduction of abandoned call rate, length of calls, and average speed answered through use of best practices and workflow improvements as defined by management. Receives incoming faxed physician orders. Verifies orders for compliance and accuracy. 4.Performs insurance eligibility verification and executes payer requirements as needed. Obtains accurate insurance benefit information from payers, such as deductible, copay, and coinsurance amounts. Utilizes patient estimation tool to calculate estimate of patient liabilities. Requires an understanding of coding, procedural protocols and the charge description master. 5.Initiates requests for authorizations, pre-certifications, notices of admission, and referrals from insurance companies. Follows up with payers and providers to ensure that authorizations are in place. Takes appropriate steps to remediate situations in which financial clearance is not completed to ensure that Nuvance Health receives prompt payment for services rendered.6. Contacts patients to perform pre-registration, including demographic verification, conveyance of insurance benefits, and estimates of liabilities. Collects on such liabilities prior to time of service utilizing provided scripting. Refers patients who express financial hardship to Financial Counseling for a financial assessment.7. Safeguards patient confidentiality by adhering to all department, organization, state, and federal compliance guidelines. Fulfills all compliance responsibilities related to the position. 8. Performs other duties as assigned.

Education Skills Experience:

HS Diploma Required. Minimum of 2-year job-related experience National Association of Healthcare Access Management (NAHAM) certification within one year of hire Basic MS Word & MS Excel. Customer service and organizational skills. Associates Degree Preferred with 6 months job-related experience.

Working Conditions:

• Manual: significant manual skills/motor coord & finger dexterity

• Occupational: Little or no potential for occupational risk

• Physical Effort: Sedentary/light effort. May exert up to 10 lbs. force

Company: Nuvance Health

Org Unit: 2071

Department: Corporate Financial Clearance

Exempt: No

Salary Range: $19.00 - $26.00 Hourly

It is Northwell Health’s policy to provide equal employment opportunity and treat all applicants and employees equally regardless of age, race, creed/religion, color, national origin, immigration status, or citizenship status, military or veteran status, sexual orientation, sex/gender, gender identity, gender expression, height, weight, disability, pregnancy, genetic information or genetic predisposition or carrier status, marital or familial status, partnership status, victim of domestic violence, their or their dependent’s sexual or other reproductive health decisions, or other characteristics protected by applicable law.