Pre-Registration and Insurance Verification Representative

6 days ago

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OU Health

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OU Health is a comprehensive healthcare provider offering a wide range of medical services including pediatric care, cancer care, diabetes care, emergency care, and specialized services for adults and children. Located in Oklahoma, OU Health operates multiple facilities such as the Oklahoma Children's Hospital and the Stephenson Cancer Center. Known for its advanced scientific research and quality care, the organization prides itself on being recognized for excellence in areas like pediatric cardiology and heart surgery. As part of its commitment to medical excellence, OU Health also focuses on medical education and research, helping to train the next generation of healthcare professionals.

Healthcare • Nursing • Critical Care • Direct Patient Care • Level I Trauma Center

10,000+ employees

⚕️ Healthcare Insurance

📋 Description

• Responsible for timely and accurate pre-registration and insurance verification. • Accurately interprets managed care contracts. • Performs pre-registration and insurance verification within 24 hours of receipt of reservation/notification. • Contacts physician to resolve issues regarding prior authorization or referral forms. • Assigns plans accurately. • Performs electronic eligibility confirmation when applicable. • Researches Patient Visit History to ensure compliance with payor specific payment window rules. • Completes Medicare Secondary Payor Questionnaire as applicable. • Calculates patient cost share and be prepared to collect via phone or make payment arrangement. • Contacts patient via phone to confirm or obtain missing demographic information. • Receives and records payments from patient for services scheduled. • Utilizes appropriate communication system to facilitate communication with hospital gatekeeper. • Performs insurance verification and pre-certification follow up for prior day’s walk in admissions.

🎯 Requirements

• High school diploma or GED required • At least three years of insurance verification experience preferred • Communication - communicates clearly and concisely, verbally and in writing • Customer orientation - establishes and maintains long-term customer relationships • Interpersonal skills - able to work effectively with other employees, patients and external parties • PC skills - demonstrates proficiency in PC applications as required • Policies & Procedures - demonstrates knowledge and understanding of organizational policies, procedures and systems • Basic skills - able to perform basic mathematical calculations, balance and reconcile figures, punctuate properly, spell correctly and transcribe accurately

🏖️ Benefits

• PTO • 401(k) • medical and dental plans • and many more.