Saint Alphonsus · 3 weeks ago
PreService Scheduling Specialist full-time days HYBRID (Boise, ID)
Boise, ID
Full-time
Hybrid
Entry Level
2+ years expSaint Alphonsus Health System is hiring a PreService Specialist to support the Regional Scheduling Team. This position is responsible for scheduling patients for services, performing insurance verification, and notifying patients of their appointments prior to services being rendered.
Health CareMedical
Responsibilities
Responsible for pre-registering the patient for upcoming visit(s) by interviewing the patient, family member and/or guarantor
Validates, obtains and enters demographic, clinical, financial, and insurance information into the patient accounting system
Utilizes multiple modes of communication (phone, fax, patient portal/e-mail, mail, etc.) and in a professional, accurate, efficient and courteous manner to obtain information and ensure good patient relations and a smooth billing process
During pre-registration calls, the position will provide information regarding directions, parking, transportation service, overnight accommodations, etc. Pre-Registration may be initiated by Scheduling staff with follow-up by the Pre-Service Specialist to ensure data integrity and completeness
Performs insurance eligibility/benefit verification, utilizing a variety of mechanisms (primarily EDI transactions and payer web access, and in some cases by calling payers directly) and documenting information within the patient accounting system. Outcomes of the insurance eligibility/benefit verification activity will determine next steps (designation as a Self-Pay account, referral to financial counseling, etc.)
Determines need for appropriate service authorizations (pre-certifications, third-party authorizations, referrals) and will contact the physician and Case Management/Utilization Review personnel, as necessary
Informs patient/guarantor of their liabilities and collects appropriate patient liabilities, including co-payments, co-insurances, deductibles, deposits and outstanding balances at the point of pre-registration. Calculates patient liabilities and provides financial education, referring the patient to financial counseling, as required. Documents payments/actions in the patient accounting system and provides the patient with a payment receipt in the collection of funds
Validates medical necessity (LCD/NCD review) of Medicare and Non-Medicare cases to ensure clinical and financial clearance. Contacts scheduling and/or ancillary department staff for clarification, if cases require clarification of diagnosis and/or test(s)/procedure(s)
Qualification
Required
High school diploma or equivalent required
Data entry skills (50-60 keystrokes per minute)
Past work experience of at least 2 years within healthcare and/or payer environment performing patient access and/or customer service activities is highly desired but not required
Preferred
Associate degree or an equivalent combination of education and experience preferred but not required
Benefits
Medical
Vision
Dental
Paid time off
403B
Education assistance
And more
Company
Saint Alphonsus
Saint Alphonsus is a four-hospital regional, faith-based Catholic ministry with more than 7,000 colleagues and providers serving more than 700,000 people in Idaho and Oregon, with outreach services to Utah, Montana, and Nevada.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
Misti Leavitt
Vice President Operations/CNO
Alexandra Oliver, RACR
Talent Sourcing Partner
Recent News
Idaho Business Review
2025-02-06
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