PreServices Representative - Rehabilitation Services - Bon Secours St. Francis Hospital

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Primary Function/General Purpose of Position

Provides administrative support for the day to day operations of the Rehabilitation Services department and will be a resource to the therapist for the electronic documentation system. Performs duties to include but not limited to filing, data entry, word processing, ordering supplies, answering phones, and scheduling patient treatment sessions. Providing excellent customer service to patients upon arrival. Gathers appropriate information from patients or responsible parties in order to completely register and verify insurance information to obtains pre-cert and authorizations for appropriate visits.

Essential Job Functions

• __ Registration/Preparing Charts. Verify evaluation details and insurance information inputted by central scheduling. Navigate in eCW and Cerner Powerchart to locate and print referral to place in chart. Assuring entry into STAR registration system provides complete, accurate information regarding referral information. Prepare patient chart for treatment and make packets of all patient paperwork that must be filled out upon arrival. When patient arrives make copy of photo ID and insurance card; explain paperwork patient needs to fill out and review insurance benefits with patient.

• Scheduling of patients/answering telephones and handling any issues/messages in timely manner. When patient arrives, verify there has not been any changes to their insurance and check them in the computer system. Verify account information to ensure their account is still open and current, follow up on insurance benefits with visit limit and expiration date. Scheduling patients in scheduling appointment book at least 2 weeks in advance.

• Submitting insurance authorizations. When a patient needs authorization, make sure the therapist provides proper documentation including plan of care, treatment note, standardized assessment tools, referral, and any insurance authorization forms. Depending on insurance the authorization can be started online, on the phone, or by faxing clinical information. Processing times very and authorization status should be checked daily. When an authorization is approved: fax approval letter to medical records; enter authorization information in Account Notes in STAR and print to notify patient and treating therapist. Once authorization has been approved and filed in the chart, call patient to schedule follow up appointment.

• Keeping track of patient accounts. Utilize the Authorization tracker to keep an eye on existing authorizations and actively count # of visits left for each patient/watch out for DOS end date. Coordinate with the therapist when the patient is reaching the end of authorization to gage whether more authorization is required or if the patient will be discharged

• Effective communication with Doctor’s offices and other disciplines/departments regarding patient care. When a new referral is needed, contact the referring physician’s office via phone or telephone encounter. If a referral is needed for a past date, ask the therapist to fill out an Additional Rehab Order Form and sign it for the requested date. Fax to referring physician. Occasional Progress Notes or Plan of Cares that fall outside of those that are automatically sent should be faxed to the referring physician for review or signature. Communicate to doctor’s offices to notify them when patients are discharging from therapy services, it patient did not show up for initial evaluation, or if there are any additional questions/requests regarding patient care.

• Retrieve and review information from EMR reports regarding account conflicts, unsigned notes and lack of documentation to support medical necessity. Review HPF queues for issues and work to resolve in timely manner to ensure all patient account information, charges, billing and follow up are accurate and complete

This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Employees may be required to perform other job-related duties as required by their supervisor, subject to reasonable accommodation.

Licensing/Certification

Education

• High School degree or equivalent education (required)

Work Experience

• Minimum of 1 year’s experience in the Customer Service Field or Call Center in a patient financial health care setting (preferred)

• Strong understanding of insurance benefits is recommended.

Training

Language

Patient Population

The following must be included in all position descriptions that involve direct or indirect patient care.  This is a Joint Commission requirement.  Also, select the age of the patient population served:

Demonstrates the knowledge and skills necessary to provide care appropriate to the age of the patients served on his or her assigned unit.

Demonstrates knowledge of the principles of growth and development of the life span and possesses the ability to assess data reflective of the patient's status and interprets the appropriate information needed to identify each patient's requirements relative to his or her age, specific needs and to provide the care needed as described in departmental policies and procedures.

Neonates (0-4 weeks)

Infant (1-12 months)

Pediatrics (1-12 years)

Adolescents (13-17 years)

Adults (18-64 years)

Geriatrics (65 years and older)

X      Not applicable to this position

Working Conditions/Physical Requirements

Frequent sitting. Frequently requires long periods of working at a computer. Intermittent walking, standing, stooping, bending. May require lifting or moving items up to 25 lbs. Frequent use of finger/hand dexterity. Constant talking or hearing. Corrected hearing and vision to normal range. No exposure to blood, body fluids or tissue. Possible exposure to infectious materials, communicable diseases and/or other conditions common to a healthcare environment. Normal office environment. Requires work under stressful conditions, deadlines, and/or irregular hours. Ability to read and comprehend. Travel may be required.

Skills

Hard/Tech/Clinical Skills :

• Strong verbal communication skills including good voice quality, diction and articulation are required.

• Must be able to communicate effectively with people of variable cultural and educational backgrounds.

• Strong math skills required. Medical terminology preferred.

• Technical skills, including proficiency with computers, PC and Windows, multi-line phone systems and headsets experience is preferred.

• The ability to handle multiple support systems is required.

• Must maintain strict confidentiality of patient demographics, concerns and financial information, as well as other sensitive information.

Soft/Interpersonal Skills:

• Customer Service skills and experience including an ability to work well with the public and an ability to adopt a customer perspective.

• Ability to diplomatically and respectfully deal with customers (both in person and via telephone).

• Must be detail oriented and possess good organizational skills

• Must be able to handle multiple priorities and deadlines

• Must demonstrate the ability work with little to no supervision and exercise independent judgment.

As a Roper St. Francis Healthcare teammate, you're part of a Mission that matters. We support your well-being—personally and professionally. Our benefits are built to grow with you and meet your unique needs, every step of the way.

What we offer

• Competitive pay, incentives, referral bonuses and 403(b) with employer contributions (when eligible)

• Medical, dental, vision, prescription coverage, HSA/FSA options, life insurance, mental health resources and discounts

• Paid time off, parental and FMLA leave, short- and long-term disability

• Tuition assistance, professional development and continuing education support

Benefits may vary based on the market and employment status

Roper St. Francis Healthcare is an equal opportunity employer.

It is our policy to abide by all Federal and State laws, as well as, the requirements of 41 CFR 60-1.4(a), 60-300.5(a) and 60-741.5(a).Accordingly, all applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability. If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact The Talent Acquisition Team at [email protected]