Pre-Visit Specialist

Job Summary

The Pre-Visit Specialist contacts all scheduled patients to obtain current demographic information, verify insurance information, collect co-payments and pre-payment amounts, and ensure pre-authorization and referral requirements are secure prior to the patients' scheduled appointments. The Pre-Visit Specialists works collaboratively with scheduling, financial counseling, referral management, authorization, and registration staff members to ensure patient wait times are minimized on the day of service. The pre-service process contributes to reduced patient wait times, improved patient satisfaction, and reduced denials stemming from front-end activities.
Essential Job Functions

• Ensures and adheres to strict confidentiality when handling patient charts, records, and scheduling information.

• Accurately pre-registers patients into the EPIC system by collecting and recording demographic, insurance, financial, and clinical data in the computer system while also recording and collecting necessary patient account documents. Verifies patient's insurance eligibility and benefits. Collects self-pay balances, pre-payment amounts, and co-pays per guidelines. Creates accounts for new patients and update accounts for previous patients to ensure accurate services and account processing.

• Interprets physician orders and referrals to determine service needs and schedule patient visits while coordinating appointments with other departments to meet the needs of the patient and provider. Calculates patients' copays, deductibles and co-insurance along with attempting to collect patient cost-sharing amounts, while working to reduce bad debt balances.

• Utilizes appropriate strategies to activate and/or verify the insurance coverage of patients and obtain information such as co-payment, and co-insurance amounts. Maintains knowledge of and complies with third-party payers' requirements for verifying insurance information, obtaining authorizations/pre-certifications, and completing other activities to ensure services are billed and reimbursed appropriately. Reviews Medicare accounts for completed Medicare Secondary Payer Questionnaire (MSPQ). Follows up on missing or incomplete pre-authorizations and contacts patient to advise them of possible financial responsibility and connect them with a financial counselor if necessary.

• Minimizes duplication of medical records by using problem-solving skills to verify patient identity through demographic details. Ensures patients have logistical information necessary to receive their service (i.e. appointment place and time, directions to facility) and thoroughly documents all conversations with patients and insurance representatives.

• Performs other duties as assigned or needed to meet the needs of the department/organization.

• Demonstrates understanding and follows infection control policies and procedures according to standard operating procedure.
• Maintains requirements for age specific competencies for the position and demonstrates the knowledge or principles of growth and developments and the skills necessary to provide patient/customer care/services.
• Demonstrates knowledge and understanding of and compliance with:
  • All pertinent safety, health and environmental policies, procedures and guidelines.
  • Working safely, without causing harm or risk to self, others or property.
  • The work environment safety procedures and prompt reporting of unsafe practices, procedures, accidents, injuries or other safety violations to the Leader.
  • The use of all safety equipment and personal protective equipment.

Driving Requirements

• Professional Drivers: Persons who drive as their main responsibility OR transport passengers or hazardous materials.
• Frequent Drivers: Persons whose main responsibility is not driving, but drive daily or almost daily.
• Occasional Drivers: Persons who drive from once per month to as frequently as once per week.
• Infrequent Drivers: Persons who are generally not expected to drive.

Driving Category

Infrequent Driver

Education & Experience
Degree/Diploma

Program of Study

Required/Preferred

Associate's

Healthcare

Preferred

Experience

Required/Preferred

A minimum of 1 year of related experience

Required
Knowledge & Skills

• Demonstrates proficient computer skills with a high degree of accuracy - variety of computer tasks.

Required

• Demonstrates excellent customer service skills.

Required

• Demonstrates the ability to be a team player, able to handle conflict and adapt to change.

Required

Physical Demands
Frequency 8 Hour Shift 10 Hour Shift 12 Hour Shift Rarely (1-4%) 1-19 min 1-24 min 1-29 min Occasionally (5-33%) 19 min-2.6 hrs 24 min-3.3 hrs 29 min-3.9 hrs Frequently (34-66%) 2.6-5.3 hrs 3.3-6.6 hrs 3.9-7.9 hrs Continuously (67-100%) 5.3-8 hrs 6.6-10 hrs 7.9-12 hrs

Activity

Frequency

Sit

Frequently (34-66%)

Stand

Occasionally (5-33%)

Walk

Occasionally (5-33%)

Stoop/Bend

Occasionally (5-33%)

Reach

Frequently (34-66%)

Climb

Not Applicable

Crawl

Not Applicable

Squat/Crouch/Kneel

Occasionally (5-33%)

Twist

Occasionally (5-33%)

Handle/Finger/Feel

Continuously (>67%)

See

Continuously (>67%)

Hear

Continuously (>67%)
Weight Demands
Activity

Amount

Lift - Floor to Waist Level

Sedentary (
Carry

Sedentary (
Push/Pull

Sedentary (
Slide/Transfer

Sedentary (

Working Conditions
Condition

Frequency

Indoor

Continuously (>67%)

Outdoor

Not Applicable

Extreme Temperature

Not Applicable

Employee Health
Functional Assessment

Hazardous Drug Exposure

Fit Testing Required

Not Applicable

No

No