POSITION SUMMARY:

　　Facilitates the conversion of referrals to admissions through the completion of the intake process and the use of effective phone and customer service skills.

　　ESSENTIAL JOB FUNCTIONS, DUTIES, AND RESPONSIBILITIES:

　　• Complete financial clearance for all referrals by determining eligibility.

　　• Process referrals to assure pre-qualifying of patients efficiently.

　　• Verifies all primary and secondary insurance information for all incoming patients to include service coverage, benefit maximums and limitations, co-insurance/co-payment, pre-existing clause, coverage

　　• Determine effective and termination dates, type of plan, and provider network status.

　　• Complete all information with attention to timely filing dates and special filing requirements.

　　• Analyze admission data and prepare assigned reports

　　• Loads all patient demographic insurance and benefit information into appropriate software system

　　• Communicates effectively with the referral sources and team members to support the business partnerships being developed by the sales team

　　• Establish positive relationships with insurers and managed care entities; Third party payors and Case Managers.

　　• Obtain complete and accurate information to facilitate the admissions process and to maximize the likelihood of reimbursement.

　　• Utilizes reports to assure accurate and timely information is documented in the appropriate software system.

　　• Excellent Communication, Customer Service & Time Management Skills

　　TRAINING, SKILLS, AND EXPERIENCE AND EDUCATION REQUIREMENTS:

　　• Associates Degree preferred

　　• 2+ years’ experience in

　　• Proficient in Microsoft Office, Word & Excel

　　• Understanding of patient compliance issues, Medicare, Medicaid and Commercial Insurance

　　• Excellent communication skills and customer service

　　• Familiarity with Medical Terminology

　　• Experience working in a call center environment

　　• Ability to multi-task, problem solve and demonstrate critical thinking skills.

　　Family Makes Us Stronger. Our family, your family, one family. Committed to loving, giving, and caring. United in making a difference.

　　We are eager to connect with you! Apply Now to get started at PruittHealth!

　　As an Equal Employment Opportunity employer, all qualified applicants will receive consideration without regard to race, color, religion, sex, national origin, disability, or veteran status.