About Job

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.