Specialist, Insurance Selection


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Posted Date: May 9th, 2017

Job Description:

Interfaces with patients, PNHS staff and third party payers to ensure accurate and timely registration. Uses effective interpersonal skills to gather necessary patient insurance and demographic information. Uses expertise in insurance selection to translate the information provided by the patient/guarantor into the computer system with the result of an accurate claim submission. Utilizes payer eligibility resources to validate patient insurance information to streamline the patient check-in process and to ensure the accuracy of claim submission. Obtains insurance pre-certifications or referrals as necessary. Works closely with PNHS staff and assists with all aspects of the registration process as appropriate.

Job requirements:

Demonstrates excellent communication skills with patients, co-workers, and external customers.

• Greets patients and acknowledges their presence as soon as possible.

• Addresses patients by name whenever possible.

• Consistently uses a pleasant tone of voice.

• Handles phone calls in a professional manner.

o Answers all calls as quickly as possible.

o Identifies department and self to caller.

o Courteously assists caller.

Maintains expected professionalism at all times.

• Strives to create the best possible experience for the patient.

• Recognizes and performs duties outside of regular job function when necessary.

• Remains calm when faced with difficult situations involving patients, families, or co-workers.

• Refrains from discussing matters related to co-workers, other patients, or personal issues.

• Responds to changes in work schedules as necessary.

• Follows established dress code policy.

• Attends meetings as required for continued skills enhancement.

• Attends mandatory department meetings that may occur outside regularly scheduled hours.

Follows established attendance guidelines.

• Begins work on time.

• Takes only scheduled breaks and lunch.

• Works additional hours as necessary.

• Adjusts to staffing changes.

• Provides advance notice for absences per PNHS policy.

• Requests PTO per PNHS policy.

Education/Experience:

Required education/experience includes:

• High school diploma or equivalent.

• Demonstrated P/C and keyboard experience.

• Demonstrated customer service skills.

• Demonstrated written/verbal communication skills.

Preferred education/experience includes:

• Post high school degree or certification.

• Healthcare registration experience, including insurance selection.

• Healthcare revenue cycle experience.

Special Knowledge/Skills/Certifications/Licenses:

• Strong attention to detail and the desire to continue to learn is necessary for on-going accuracy.

• The incumbent will be expected to complete a competency examination on insurance selection/process upon completion of training and annually thereafter.

• The incumbent will be expected to demonstrate competency on insurance selection/process on a monthly basis.

Union Name: Non-Union

Job Code: P5NL

Department: Reception

Job Number: 44546

Status: Full Time

Work Schedule: Monday-Friday 8:00am-5:00pm

Site: TRIA Woodbury

Hours/Pay Period: 80

Benefit Eligible: Yes