Job Description

General Purpose of Job:

The Pre-Service Specialist's main objective is to accurately schedule and pre-register patients for Sparrow Health System and secure patient payments for those services. Responsibilities include: scheduling patient appointments, providing pre-registration, verification of insurance, obtaining insurance authorizations, collecting patient payments, providing estimates, entering ICD-10 codes and completing appropriate medical necessity checking.

Essential Duties:

This job description is intended to cover the minimum essential duties assigned on a regular basis. Associates may be asked to perform additional duties as assigned by their leader. Leadership has the right to alter or modify the duties of the position.

• Interview patients and/or physician offices for the purpose of scheduling and pre-registration. Collect accurate demographic and financial information to assist with billing requirements.
• Enter appropriate ICD-10 codes for registration and billing purposes at the point of scheduling and registration.
• Verify medical necessity checks upon scheduling a patient.
• Verify insurance eligibility and covered benefits.
• Collect and verify necessary insurance authorizations.
• Educate the patient as to their financial responsibility prior to the point of service. Provide estimates for services as requested by the patient.
• Collect pre-payment for hospital services that are not covered by the patient's insurance, including co-pays, deductibles, or prior patient balances. Set up payment arrangements with patients when appropriate.
• Process accounts held internally or rejected by payers for errors related to registration, authorization and financial clearance activities..

Job Requirements

General Requirements	*Demonstrates knowledge and maintains and respects patient right to privacy by following the HIPAA Privacy and Security policies and procedures. *Adheres to ICARE values and standards of behavior (Innovation, Compassion, Accountability, Respect, Excellence). *Role model behaviors that value the diversity of our associates, patients and customers and supports creating an environment that is inclusive, welcoming and respectful. *Communicates with patients, families and customers using AIDET (Acknowledge, Introduce, Duration, Explanation, Thank). *Works in a safe manner and promptly reports any hazards identified in the work environment or related to assigned responsibilities.
Work Experience	*Experience must be in one of the following areas: billing, health insurance verification, ICD-10 coding, medical necessity checking, authorizations and copay collections.
Education	*Associate Degree in health care billing, accounting or business and a minimum of 1 year of health care scheduling and patient registration experience; OR High School Diploma/GED and a minimum of 3 years of health related experience in billing, registration and scheduling.
Specialized Knowledge and Skills	* Excellent word processing and computer typing skills. * Demonstrated interpersonal and communication skills * Must pass a medical terminology assessment test with 80% or greater. * Must successfully complete analytical skills assessment test with 65% or greater.