Parallon is one of the country’s largest premier revenue cycle partners, with more than 15,800 employees serving 600 hospitals and 3,000 physician practices. Annually, we collect more than $41 billion and interact with 37 million patients. Our track record of results is among the best in the industry. We serve hospitals, physician practices and healthcare systems by bringing deep operational knowledge and tailored revenue cycle solutions so that providers can focus on fulfilling their mission.
Shift Hours: Mon - Fri 11am - 7:30pm
JobSummary– The P T AC C e n tra l U nit Representative isresponsiblefortimelyandaccurateprocesses associated withsomeorallofthe following:
· Pre-Certification · InsuranceNotification
Duties (included but notlimitedto): Duties will be performed byeachindividualdependingonassignmentofresponsibilities:
· Perform pre-registration and insurance verification within 3 - 5 d ay s prio r to d ate of s erv ic e for both inpatient and outpatient services. For notification received with less than 3days’advancednoticeperformwithin24hoursofnotification.
· Follow scripted benefits verification and pre-certification format in Meditech custom benefits screen and record benefits and pre-certification information in the approved standard format
· Assign I nsuran ce P lans (IPlan’s) accurately
· Perform electronic insuranc e eligibility confirmation when applicable and document results
· Complete Medicare Secondary Payor Questionnaire asapplicableforretentioninimagingsystem(i.e.OnBase)
· Calculate patient cost share andbepreparedtocollectviaphoneormakepaymentarrangement
· Receive and record payments from patient for services scheduled.
· Utilize appropriate communication system to facilitate communication with hospital gatekeeper
· Ensure approp r ia te do c um e n ta tion is e nt ere d in s ta nda r d format on the patient record. This should be per fo rme d in the appli c abl e Health I nfo rm ation S y s tem (i.e. Me di tec h) and if necessary any o t h er subsidiary systems if they are not au t o mat ically updated.
· Contact physician to resolve issues regarding prior authorization orreferralforms
· Research Patient Visit History to ensure compliance with payor specific payment windowrules
· Perform insurance verification and pre-certification followupforpriorday’swalkinadmissions/registrationsandaccountstatuschangesbyassignedfacilityasperSSC guidelines.
· Co m muni cate s with hospital based Case Ma na ger as necessary to ensure p ro mp t re solu t ion of pre- existing,non-covered,andre-certificationissues
· Meets/exceeds performance expectations and completes work within the required time frames
· Implements and follows system downtime procedures when necessary
· Practice and adhere to the “Code of Conduct” philosophy and “Mission and Value Statement”
· Other duties asassigned
KNOWLEDGE, SKILLS &ABILITIES · Communication -communicatesclearlyandconcisely,verballyandinwriting.Thisincludesutilizingproperpunctuation,correct spellingandtheabilitytotranscribeaccurately.
· Customer orientation -establishesandmaintainslong-termcustomerrelationships,buildingtrustandrespectbyconsistentlymeetingandexceedingexpectations
· Interpersonal skills -abletoworkeffectivelywithotheremployees,patientsandexternalparties
· PC skills -demonstratesproficiencyinMicrosoftOfficeapplicationsandothersasrequired
· Policies&Procedures -demonstratesknowledgeandunderstandingoforganizationalpolicies,proceduresandsystems
· Basic skills -demonstratesabilitytoorganize,performandtrackmultipletasksaccuratelyinshorttimeframes,haveabilitytoworkquicklyandaccuratelyinafast-pacedenvironmentwhilemanagingmultipledemands,abilitytoworkbothindependentlyandcollaborativelyasateamplayer,adaptability,analyticalandproblemsolvingabilityandattentiontodetailandabletoperformbasicmathematicalcalculations,balanceandreconcilefigures,punctuateproperly,spellcorrectlyandtranscribeaccurately.
High school diploma orGEDrequired.
PHYSICAL DEMANDS/WORKING CONDITIONS
Requiresprolongedsitting/standing,somebending,stooping,walkingandstretching.Requireseye-handcoordinationandmanualdexteritysufficienttooperateakeyboard,photocopier,telephone,calculatorandotherofficeequipment.Requiresnormalrangeofhearingandeyesighttorecord,prepareandcommunicateappropriatereportsorotherinformation.Requiresliftingpapers/boxesandpushing/pullingupto25poundsoccasionally.Workisperformedinanofficeenvironmentorhospitalsetting.Workmaybestressfulattimes.Contactmayinvolvedealingwithangryorupsetpeople.Staffmustremainflexibleandavailabletoprovidestaffingassistancefor any/all disaster oremergencysituations.
OSHA CATEGORY – Thenormalworkroutineinvolvesnoexposuretoblood,bodyfluids,ortissues(althoughsituationscanbeimaginedorhypothesizedunderwhichanyone,anywhere,mightencounterpotentialexposuretobodyfluids).Personswhoperformthesedutiesarenotcalleduponaspartoftheiremploymenttoperformorassistinemergencycareorfirstaid,ortobe potentiallyexposed insomeotherway.
Parallon/HCA is an equal opportunity workforce and no one shall discriminate against any individual with regard to race, color, religion, sex, national origin, age, disability, sexual orientation, gender identity or expression, genetic information or veteran status with respect to any offer, or term or condition, of employment. We make reasonable accommodations to the known physical and mental limitations of qualified individuals with disabilities.
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