岗位职责:

1. Contacts iurance companies to determine patient’s international iurance benefits. Verify patient eligibility and pre-certification requirements through On-line verification software, email or by telephone

2. Obtai requirements for claim submission and pre-certification process from iurance companies

3. Determines contract and benefit eligibility for pre-certification, prior authorization of inpatient and outpatient services

4. Works with patients in securing prepayment sources or financial agreements prior to providing service

5. Maintai the pre-certification related information in the system to eure its accuracy

6. Verifies the coverage of benefit and asks for the payment guarantee in advance to expeive examinatio for all outpatients

7. Assists patient on iurance coverage related matte

8. Responds to and follows through on patient and iurance related inquiries

9. Conducts financial screening for all inpatients (Observation, Day Surgery, Admission)

10. Coordinates and awe inpatient inquiries

11. Coordinates on discharge process, prepares itemized interim statement upondischarge

12. Maintai strictest confidentiality of patient information

13. Assists other office peonnel in the performance of their duties as assigned and performs related work as required

14. Serve as liaison with the iurance company, hospital and client.

15. May also manage appeals for services denied.

16. Assists in training new employees of the Pre-certification team.

任职资格:

1. Minimum education- the completion of Junior College

2. Working experience in BJU or a similar health care organization or a business setting desired

3. Must be flexible to work third shifts

4. Additional educatioexperience may be substituted for experience/education

5. Excellent oral and written English

6. Independent decision making

7. Professional telephone etiquette

8. Good time management skills and must be able to prioritize

9. Must be flexible to work third shifts

10. Basic computer skills

11. Must work well under pressure and be able to work on multiple tasks simultaneously.

12. Knowledge of medical terminology and iurance industry preferred

13. Knowledge of clinic charging, coding and iurance billing procedures preferred (but trainable)