Preregistration Specialist

Entity: Clinical Practices of the University of Pennsylvania (CPUP)

Department: RAD-O-RBO Prereg

Location: Centre Square West Tower- 1500 Market Street

Hours: Fulltime, Monday-Friday, 8:00am - 4:30pm, Hybrid

Summary:

The Pre-registration specialist reports to the Supervisor of Financial Clearance, and directly communicates with patients to verify patient demographics and insurance information. Ensures all financial obligations are communicated to patients clearly, are updated on the account, and are detailed to ensure expeditious processing of patient accounts. This position conducts insurance eligibility checks, verifies insurance information, obtains authorizations/referrals if necessary and if appropriate collects patient responsibility for patients prior to care. Accurately identifies primary and secondary payers. This individual will relay relevant financial information (e.g., price estimates and payment plan options) in a clear and patient-friendly manner. This position works collaboratively with scheduling, financial counseling, and registration staff members to ensure patient wait times are minimized on the day of service.

Responsibilities:

• Obtains and documents specific details related to the authorization including effective and end dates using the appropriate legacy system and associated software application via patient notes, authorizations, tasks, workflow, phone calls and/or email.
• Obtains information to complete Medicare Secondary Payer Questionnaire and other payer specific documents as required.
• Certifying patient demographic, insurance, and financial data collected during scheduling and pre-registration activities.
• Appropriately collects and/or sets payment arrangements with patients or their representative, scheduling payments on deposits due, which may include screening of patients for enrollment in available credit option programs.
• Effectively communicates with payer to determine extent of coverage and other limitations or co-payments provisions. Maintains knowledge of and complicates with each payer’s requirements for verifying insurance and obtaining pre-authorizations/ pre-certifications.
• Documents all information obtained during pre-registration activities. Identifies un-and underinsured and low-income patients; refers them to staff who can help with financial assistance options and other arrangements prior to patient visit.

Additional Duties:

• Performs duties in accordance with Penn Medicine and entity values, policies, and procedures.
• Other duties as assigned to support the unit, department, entity, and health system organization.

Qualifications:

• High School Diploma/GED
• And 3+ years' work experience in Patient Access, Medical Billing, or Customer Service

Skills and Abilities:

• Experience in pre certification requirements, CMS medical necessity requirements, and third party billing processing.
• Familiarity with federal regulations and other guidelines for patient registration and collections.
• Knowledge of medical terminology.
• Excellent customer service skills (preferred).
• Negotiation and problem solving skills (preferred).
• Ability to prioritize and handle multiple tasks (preferred).
• Ability to communicate clearly both verbally and in writing (preferred).
• Ability to work productively as part of a team (preferred).