Preservice Specialist I
Nuvance Health, Danbury, CT, United States
At Nuvance Health, we enjoy the benefits of a two-state system as we cultivate an inclusive culture where everyone feels welcomed, respected and supported. Together, we are a team of 15,000+ strong hearts and open minds. If you share our values of connected, personal, agile and imaginative, we invite you to discover what’s possible for you and your career.
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
Schedule patients for hospital or medical group services by incoming phone calls, online requests, or outbound to patients.
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, promoting in‑system retention of patients and continuity of care.
Provide excellent customer service to physician offices and patients, contribute 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; receive incoming faxed physician orders and verify orders for compliance and accuracy.
Perform insurance eligibility verification and execute payer requirements as needed, obtaining accurate insurance benefit information from payers such as deductible, copay, and coinsurance amounts; utilize the patient estimation tool to calculate estimate of patient liabilities and understand coding, procedural protocols and the charge description master.
Initiate requests for authorizations, pre‑certifications, notices of admission, and referrals from insurance companies; follow up with payers and providers to ensure that authorizations are in place and take appropriate steps to remediate situations in which financial clearance is not completed to ensure that Nuvance Health receives prompt payment for services rendered.
Contact patients to perform pre‑registration, including demographic verification, conveyance of insurance benefits, and estimates of liabilities; collect such liabilities prior to time of service utilizing provided scripting; refer patients who express financial hardship to Financial Counseling for a financial assessment.
Safeguard patient confidentiality by adhering to all department, organization, state, and federal compliance guidelines and fulfill all compliance responsibilities related to the position.
Perform other duties as assigned.
Education, Skills & Experience
HS Diploma required; minimum of 2‑year job‑related experience.
NAHAM certification within one year of hire.
Basic MS Word and MS Excel proficiency.
Customer service and organizational skills.
Associate’s degree preferred with 6 months job‑related experience.
Compensation
Salary Range: $18.13 - $26.00 Hourly.
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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
Schedule patients for hospital or medical group services by incoming phone calls, online requests, or outbound to patients.
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, promoting in‑system retention of patients and continuity of care.
Provide excellent customer service to physician offices and patients, contribute 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; receive incoming faxed physician orders and verify orders for compliance and accuracy.
Perform insurance eligibility verification and execute payer requirements as needed, obtaining accurate insurance benefit information from payers such as deductible, copay, and coinsurance amounts; utilize the patient estimation tool to calculate estimate of patient liabilities and understand coding, procedural protocols and the charge description master.
Initiate requests for authorizations, pre‑certifications, notices of admission, and referrals from insurance companies; follow up with payers and providers to ensure that authorizations are in place and take appropriate steps to remediate situations in which financial clearance is not completed to ensure that Nuvance Health receives prompt payment for services rendered.
Contact patients to perform pre‑registration, including demographic verification, conveyance of insurance benefits, and estimates of liabilities; collect such liabilities prior to time of service utilizing provided scripting; refer patients who express financial hardship to Financial Counseling for a financial assessment.
Safeguard patient confidentiality by adhering to all department, organization, state, and federal compliance guidelines and fulfill all compliance responsibilities related to the position.
Perform other duties as assigned.
Education, Skills & Experience
HS Diploma required; minimum of 2‑year job‑related experience.
NAHAM certification within one year of hire.
Basic MS Word and MS Excel proficiency.
Customer service and organizational skills.
Associate’s degree preferred with 6 months job‑related experience.
Compensation
Salary Range: $18.13 - $26.00 Hourly.
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