Precertification Specialist – Financial Clearance Dept.

Lakeshore Talent
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Lakeshore Talent is partnered with a leading Healthcare network in their search for Precertification Specialists for several contract roles of approximately 3 months with the possibility of extension and/or hire. Our client is seeking candidates with precertification experience and a passion for helping others!
LOCATION: Warrenville, IL
PAY RATE: $19/hr
HOURS: 8:30am-5pm Monday to Friday
RESPONSIBILITIES:
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Responds to telephone inquiries and performs appropriate action(s)
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Documents all actions taken in the appropriate software applications
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Monitors admission / registration and scheduled surgeries flow of patient information through the revenue cycle
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Serves as a resource to staff and patients for insurance related issues
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Reviews patient electronic medical record for appropriate diagnosis and pre-treatment rendered
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Consults with physicians and their assistants whenever questions arise to insure timely approvals
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Follows through and makes corrections in demographics and insurances as they are discovered
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Insures all admissions, scheduled surgeries, and certain outpatient procedures are financially cleared, to allow for maximum and timely reimbursement to the hospital
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Interacts with various hospital departments and physicians offices to effectively schedule and direct patients through systems in a patient/customer friendly manner
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Performs medical necessity checks as necessary for scheduled services, communicates options to patient if appointment fails
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Informs patients of any issues with securing the financial account for their encounter and completes out-of-pocket estimations as requested by patients
REQUIREMENTS:
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Post high school education preferably a degree in Accounting or Finance
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Customer service experience preferably in a hospital setting
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Familiarity with insurance plans, EPIC and Medicare and Medicaid
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