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Minimum of 1 year of specialized training in a health care setting with demonstrated knowledge of insurance verification and working knowledge of authorization and pre-certification process preferred.
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The Ambulatory Office Specialist is responsible for the Patient Access functions for ambulatory services identified in the ambulatory setting, including, but not limited to, facility based scheduling, pre-registration, registration, insurance verification, pre-certification, work queues, and financial clearance, under the direction of the practice mangers/directors.
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Our services include scheduling, registration, insurance verification, hospital billing, revenue integrity, collections, payment compliance, credentialing, health information management, customer service, payroll and physician billing.
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Verifies insurance benefits and obtains pre-certification from various third-party payers. Examples of documents: insurance cards, financial agreements, ER charge sheets, verification sheets, pre-certification letters and physician orders.
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Experience Requirements Experience with third party payer billing regulations, reimbursement requirements, precertification, insurance eligibility verification, and/or utilization management is preferred.
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Perform pre-registration at a minimum of 1 day prior to date of service for all in scope services. Our Talent Acquisition team is reviewing applications for our Pre-Registration Representative opening.
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Secures all demographic and financial registration information including: Registration, Pre-registration, Insurance verification, Third Party Liability (TPL) screening, Medi-Cal/Medicare eligibility verification, Workers Compensation eligibility, Securing cash deposits (co-pays, deductibles, cash packages.
$19.5 - $28.55 an hourFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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We are looking for a dedicated Pre-Registration Representative like you to be a part of our team. Do you want to join an organization that invests in you as a Pre-Registration Representative.
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Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
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This position is also responsible for verifying patient insurance, confirming benefits eligibility, performing pre-authorization, pre-certification, and/or notification as required by third party providers.
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Regulatory Compliance: Stay updated on relevant laws, regulations, and industry best practices related to third-party risk management. Knowledge of and experience with third-party risk management governance, policies, and organizational structures.
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Coordinates both the Verification of Benefits and Authorization/Pre-Certification/documentation (PA) processes for patients by: Verifying insurance coverage by calling the insurance company or using online eligibility systems to determine the patient's benefits under the insurance plan.
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Oversee efforts to influence enhance and mature of Third-Party Risk Management Program and resolutions, in line with the enterprise risk management framework. + Develop strong working relationships across Third-Party Risk Management ecosystem to ensure focused and efficient support.
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Third Party Risk management encompasses evaluating suppliers across all operational risk domains including: Technology, Information, Operational Resiliency, Processes/Transactions, Models, Reporting and Fourth Party.
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Purpose: The Senior Specialist Third Party InfoSec Risk is responsible for applying, collaborating, and supporting the Third Party Risk Management Program strategic vision in the execution of day-to-day functions as it applies to PPFA and Affiliates.
$87,000 - $97,000 a yearFull-timeExpandApply NowActive JobUpdated Today
pre registration insurance verification third party jobs Company: Summa Western Reserve Hospital
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