Job Summary:
The PTAC Central Unit Representative is responsible for timely and
accurate processes associated with some or all of the following:
- Pre-registration
- Insurance verification
- Pre-Certification
- Insurance Notification
**Responsibilities**:
Duties (included but not limited to):
Duties will be performed by each individual depending on assignment of responsibilities:
- Perform pre-registration and insurance verification within 3-5 days prior to date of service for
both inpatient and outpatientservices. For notification received with less than 3 days'
advanced notice perform within 24 hours of notification.
- 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 Insurance Plans (IPlan's) accurately
- Perform electronic insurance eligibility confirmation when applicable and document results
- Complete Medicare Secondary Payor Questionnaire as applicable for retention in imaging
system (i.e. OnBase)
- Calculate patient cost share and be prepared to collect via phone or make payment
arrangement
- Contact patient via phone (with as much advance notice as possible, preferably 48 hours prior
to date of service)to confirmor obtain missing demographic information, quote/collect patient
costshare, and instruct patient on where to present at time of appointment
- Receive and record payments from patient for services scheduled.
- Utilize appropriate communication system to facilitate communication with hospital
gatekeeper
- Ensure appropriate documentation is entered in standard format on the patient record. This
should be performed in the applicable Health Information System (i.e. Meditech) and if
necessary any other subsidiary systems if they are not automatically updated.
- Contact physician to resolve issuesregarding prior authorization or referral forms
- Research Patient Visit History to ensure compliance with payor specific payment window
rules
- Perform insurance verification and pre-certification follow up for prior day's walk in
admissions/registrations and account status changes by assigned facility as per SSC
guidelines.
- Communicates with hospital based Case Manager as necessary to ensure promptresolution of
pre
- existing, non-covered, and re-certification issues
- Meets/exceeds performance expectations and completes work within the required time
frames
- Implements and followssystem downtime procedures when necessary
- Practice and adhere to the "Code of Conduct" philosophy and "Mission and Value Statement"
- Other duties as assigned
Skills and Experience:
- Communication - communicates clearly and concisely, verbally and in writing. This includes
utilizing proper punctuation, correct spelling and the ability to transcribe accurately.
- Customer orientation - establishes and maintains long-term customer relationships,
building trust and respect by consistently meeting and exceeding expectations
- Interpersonal skills - able to work effectively with other employees, patients and external
parties
- Policies & Procedures - demonstrates knowledge and understanding of organizational
policies, procedures and systems
- Basic skills - demonstrates ability to organize, perform and track multiple tasks accurately in
short timeframes, have ability to work quickly and accurately in a fast-paced environment
while managing multiple demands, ability to work both independently and collaboratively
as a team player, adaptability, analytical and problem solving ability and attention to detail
and able to perform basic mathematical calculations, balance and reconcile figures,
punctuate properly, spell correctly and transcribe accurately.
About Auxis:
Auxis prioritizes employee growth and development to help you advance your career. Auxis' culture empowers you to be your best in the interest of a common team goal. We are constantly striving to improve our culture and environment and have invested in tools to continue to have better visualization of the pulse of our organization.
- Benefits_
- Health benefits including medical, vision, and dental.
- Transportation subsidy
- Asociacion Solidarista
- Training and development programs
- Employee recognition program
- Paid time off and family paid leave
- Paid day off for your birthday!