Prisma Health
PB - Ins & Pre-Registration Rep, BMPG Cardiology, Blount, Full-Time, Days
Prisma Health, Maryville, Tennessee, United States, 37803
Job Title
PB - Ins & Pre-Registration Rep, BMPG Cardiology, Blount, Full-Time, Days
Company : Prisma Health
Job Summary Verifies insurance coverage/benefits and current patient responsibility using online eligibility tools, website or telephone inquiry to the insurance administrator and/or third‑party payor, ensuring coverage is listed accurately. Initiates, obtains, and documents pre‑certification/prior authorizations as required by Departmental Guidelines.
Essential Functions
All team members are expected to be knowledgeable and compliant with Prisma Health's purpose: Inspire health. Serve with compassion. Be the difference.
Verifies insurance coverage/benefits utilizing online eligibility, websites or telephone inquiry to the insurance administrator and/or third‑party payor. Information obtained must be documented accurately and completely in EPIC.
Ensures insurance priorities are correct based on third‑party requirements/COB.
Identifies current patient responsibility using insurance eligibility and benefit responses. Documents patient responsibility per Departmental Guidelines.
Initiates, obtains, and documents pre‑certifications /prior authorizations as required by Departmental Guidelines.
Communicates new insurance system issues to appropriate personnel; manually corrects/updates current identified insurance issues until correction is implemented.
Performs other duties as assigned.
Supervisory/Management Responsibilities This is a non‑management job that will report to a supervisor, manager, director or executive.
Minimum Requirements
Education: High School diploma or equivalent or post‑high school diploma, or highest degree earned.
Experience: Two (2) years billing, bookkeeping, or accounting experience.
Required Certifications, Registrations, Licenses NA
Knowledge, Skills, and Abilities
Maintains up‑to‑date knowledge regarding current insurances, including which plans run through the system, ways to fix errors, and methods for verifying eligibility and benefits for insurances that do not run through the system.
Maintains up‑to‑date knowledge of current managed care contracts and utilizes correct network or out‑of‑network status for each insurance.
Work Shift Day (United States of America)
Location Blount Memorial Hospital
Facility 8104 BH POB Maryville
Department 81041005 BMPG Cardiology Maryville
Additional Information Share your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.
#J-18808-Ljbffr
Company : Prisma Health
Job Summary Verifies insurance coverage/benefits and current patient responsibility using online eligibility tools, website or telephone inquiry to the insurance administrator and/or third‑party payor, ensuring coverage is listed accurately. Initiates, obtains, and documents pre‑certification/prior authorizations as required by Departmental Guidelines.
Essential Functions
All team members are expected to be knowledgeable and compliant with Prisma Health's purpose: Inspire health. Serve with compassion. Be the difference.
Verifies insurance coverage/benefits utilizing online eligibility, websites or telephone inquiry to the insurance administrator and/or third‑party payor. Information obtained must be documented accurately and completely in EPIC.
Ensures insurance priorities are correct based on third‑party requirements/COB.
Identifies current patient responsibility using insurance eligibility and benefit responses. Documents patient responsibility per Departmental Guidelines.
Initiates, obtains, and documents pre‑certifications /prior authorizations as required by Departmental Guidelines.
Communicates new insurance system issues to appropriate personnel; manually corrects/updates current identified insurance issues until correction is implemented.
Performs other duties as assigned.
Supervisory/Management Responsibilities This is a non‑management job that will report to a supervisor, manager, director or executive.
Minimum Requirements
Education: High School diploma or equivalent or post‑high school diploma, or highest degree earned.
Experience: Two (2) years billing, bookkeeping, or accounting experience.
Required Certifications, Registrations, Licenses NA
Knowledge, Skills, and Abilities
Maintains up‑to‑date knowledge regarding current insurances, including which plans run through the system, ways to fix errors, and methods for verifying eligibility and benefits for insurances that do not run through the system.
Maintains up‑to‑date knowledge of current managed care contracts and utilizes correct network or out‑of‑network status for each insurance.
Work Shift Day (United States of America)
Location Blount Memorial Hospital
Facility 8104 BH POB Maryville
Department 81041005 BMPG Cardiology Maryville
Additional Information Share your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.
#J-18808-Ljbffr