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The University of Kansas Health System · 2 days ago

CA Pre-Registration/Pre-Certification Specialist

United States

Full-time

Remote

Entry Level

1+ years exp

The University of Kansas Health System is seeking a CA Pre-Registration/Pre-Certification Specialist. This role is responsible for identifying patients who qualify for pre-registration and ensuring accurate demographic and insurance information is obtained and entered into the registration system.

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Growth Opportunities

Responsibilities

Works reports daily according to duty specifications to retrieve all un-contacted patients prior to service. Utilizes worklists to pre-register / pre-certify hospital services

Conducts telephone interviews as needed with patients to elicit demographic information and third-party payer data that will be needed for billing purposes

Enters patient data directly into registration systems. Ensures that MSPQ is completed when appropriate

Verifies with third party payor dependent eligibility, certificate and group numbers, co-payment and deductible amounts, statement mailing address, etc. Complies with Medicare / Medicaid and other insurance rules and regulations

Works closely with the clinics, hospital ancillary departments, and patient financial advisors regarding potential complications regarding insurance coverage

Secures accounts per established departmental policy. This includes but is not limited to, contacting the patient, contacting responsible payers including government and non-government payers, contacting the patient’s employer, referring uninsured and underinsured accounts to the Financial Advisors, and taking any other necessary actions. Contact provider office immediately of any restrictions denying services, such as inability to obtain pre-certification or any lock-in program by any agency

Must be able to perform the professional, clinical and or technical competencies of the assigned unit or department

These statements are intended to describe the essential functions of the job and are not intended to be an exhaustive list of all responsibilities. Skills and duties may vary dependent upon your department or unit. Other duties may be assigned as required