CALL CENTER REPRESENTATIVE
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- Verifies insurance benefits.
- Processes accounts to ensure that patients are preregistered & required insurance authorizations and/pre-certifications are obtained prior to the date of service.
- Communicates with patients and insurance companies regarding coverage, deposits, and other related matters. Discusses benefits with patients, responds to patient/third party inquiries, and makes referrals. Schedules patient’s procedures. Informs patients of pre-op instructions.
- Performs scheduling/referral duties according to established procedures.
- Prepares patient schedules/documentation for departments.
- Completes insurance verification/pre-certification according to payor requirements; identifies outpatient procedures that require pre-certification/second opinion; obtains required information from physician; pre-certifies inpatient admissions.
- Requests pre-payments and informs patients of discounts.
- Completes Medicare Questionnaire; ensures that medical necessity is established for Medicare/Medicaid patients.
- Others roles and responsibilities as assigned.