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MO-SSM Health Mission Hill

Worker Type:

Regular

Job Summary:

Secures scheduled encounters by verifying insurance, identifying, and completing payer authorization requirements, creating, and communicating estimated patient liabilities preservice.

Job Responsibilities and Requirements:

PRIMARY RESPONSIBILITIES

• Gathers incoming work orders, clinical information, interviews client/referral source to secure demographic, financial, and qualifying data, while timely securing verification and authorization of benefits; records accurate information to support data integrity and maximize reimbursement potential.

• Verifies insurance details, documents insurance benefits, produces price estimates, and communicates with patients regarding pre-registration and collection items.

• Works collaboratively with insurance companies, providers and staff to ensure plan requirements have been met prior to patient services being rendered in order to maximize reimbursement.

• Operates computer system to record/document and retrieve information to ensure appropriate agency services are provided in a timely manner.

• Effectively utilizes medical terminology to collaborate with physicians, case managers, and branch leaders to effectively identify and coordinate patient care needs.

• Responsible for management of EPIC in-basket and other requested authorizations across the system; specifically reviewing work queues.

• Educates patients and clinical caregivers regarding referral, authorization requirements, payer coverage, eligibility guidelines, and other insurance related changes.

• Completes annual education and licensing requirements timely and at a satisfactory level.

• Works in a constant state of alertness and safe manner.

• Performs other duties as assigned.

EDUCATION

• High School diploma/GED or 10 years of work experience

EXPERIENCE

• 1-3 years’ experience in a medical business office or health care setting involving customer service or patient-facing responsibilities, or equivalent

PHYSICAL REQUIREMENTS

• Frequent lifting/carrying and pushing/pulling objects weighing 0-25 lbs.

• Frequent sitting, standing, walking, reaching and repetitive foot/leg and hand/arm movements.

• Frequent use of vision and depth perception for distances near (20 inches or less) and far (20 feet or more) and to identify and distinguish colors.

• Frequent use of hearing and speech to share information through oral communication. Ability to hear alarms, malfunctioning machinery, etc.

• Frequent keyboard use/data entry.

• Occasional bending, stooping, kneeling, squatting, twisting and gripping.

• Occasional lifting/carrying and pushing/pulling objects weighing 25-50 lbs.

• Rare climbing.

REQUIRED PROFESSIONAL LICENSE AND/OR CERTIFICATIONS

• None

Work Shift:

Day Shift (United States of America)

Job Type:

Employee

Department:

8071000114 Intake/Admissions

Scheduled Weekly Hours:

40

Benefits:

SSM Health values our exceptional employees by offering a comprehensive benefits package to fit their needs.

• Paid Parental Leave : we offer eligible team members one week of paid parental leave for newborns or newly adopted children (pro-rated based on FTE).

• Flexible Payment Options: our voluntary benefit offered through DailyPay offers eligible hourly team members instant access to their earned, unpaid base pay (fees may apply) before payday.

• Upfront Tuition Coverage : we provide upfront tuition coverage through FlexPath Funded for eligible team members.

Explore All Benefits (https://jobs.ssmhealth.com/us/en/benefits)

SSM Health is an equal opportunity employer. SSM Health does not discriminate on the basis of race, color, religion, national origin, age, disability, sex, sexual orientation, gender identity, pregnancy, veteran status , or any other characteristic protected by applicable law. Click here to learn more. (https://www.ssmhealth.com/privacy-notices-terms-of-use/non-discrimination?_ga=2.205881493.704955970.1667719643-240470506.1667719643)