Precertification Specialist - Biloxi Central Scheduling - Days - FT- Biloxi Location

The Precertification Specialist I is responsible for verifying patient demographics and insurance benefits, assuring authorizations for service are in place, and informing patient of estimated payment amount. The Precertification Specialist I maintains a resource schedule and acts as a liaison with the patient, provider, physician, and insurance companies. Ensures completeness and integrity of patient registration Verifies and documents patient demographics, guarantors, and insurance information Validates correct insurance at the time of registration and maintains a 4% or less error rate Completes the pre-admission processes specific to assignment Monitors schedules of assigned areas for added tests or procedures Documents all accounts with pertinent information not limited to follow-up needed by hospital personnel Performs financial processes and communicates patient's responsibility Creates estimates of charges based on available information and collects pre-payments when necessary Communicates financial options to patients prior to testing with possible referral to Financial Counselors Screens testing urgency based on patient's ability to pay Balances cash sheets and audits Assures the MHG financial policy qualifications are met Monitors authorization status and alerts Provider Staff or Precertification Specialist II if not received at least 3 days prior to date of service Obtains copies of authorizations for non-MHG providers to receive reimbursement for MHG Communicates with provider to modify testing/procedure orders to a medically necessary diagnosis based on payer guidelines

Education Requirement Required:

High School Diploma or GED equivalent

Preferred:

Certification or vocational training

Experience Requirement Required:

Minimum of one year previous clerical experience

Preferred:

Minimum years of relevant experience 2-4