PRE-PROCESSING REPRESENTATIVE - FULL TIME - DAYS

Job Requisition #: JR58154

End Date: 6/28/2022

Location: Elkton, Maryland

Position Type: Clerical/Administrative/Billing

Shift: Day Shift, No Rotation

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ChristianaCare, Union Hospital is looking for a detail-oriented Pre-Processing Representative to join our team! Schedule: - Monday - Friday - Days - Attendance at special events as requested. - Potential for occasional weekend or holiday assignments/projects Job Summary: Provides insurance verification and authorizations for all scheduled and unscheduled outpatient services, through contact with insurance companies, physicians, employers, patients and patients' families while increasing patient satisfaction. Essential Job Functions: - Demonstrates overall knowledge of authorization, benefits and claims processing for insurance payers and managed care plans. - Obtains and documents benefits in the BAR system for cash collection and billing follow up. - Communicates in a friendly and professional manner with physicians and insurance companies to ensure proper authorizations and paperwork are completed in a timely manner prior to patients services. - Manage daily work list that is inclusive of both hospital and offsite diagnostic centers. - Communicates with third party vendors and payers. - Reviews all self pay patients for possible coverage including hospital system and also sends to Navigators for possible coverage and reviews patients ability to pay, etc. - Properly notifies physician offices of scheduled studies for their patients while working with physician office staff to continue precertification requirements and clinical information and follow up with patient and office of any authorization issues and concerns. - Communicates with offsite centers and hospital departments when there are discrepancies, authorization issues or problems to resolve in a timely manner to include cancel patients or reschedule patients as required. - Provides documentation that is very clear and detailed for follow up purposes (ie; phone numbers, names of representatives, reference call numbers, authorization numbers, etc). - Collaborates with billing staff to resolve denial trends, prepares denial documentation to billing staff when necessary. - Verifies and updates all insurance information, demographics, etc. to ensure prompt and proper payment of the claim. Education: High School Diploma or GED equivalent required. Some college course work preferred. Licenses/ Certifications: None Required. Experience: Previous healthcare or related experience preferred.

Why do WE offer careers full of possibilities?

For the Love of Health.

Inclusion & Diversity

At ChristianaCare, we’re committed to treating everyone with dignity and respect. We believe in a safe, inclusive work environment that fosters collaboration between caregivers from all walks of life. We know that each unique viewpoint is vital in delivering high-quality, safe patient care to everyone who walks through our doors. Our policies, benefits, hiring practices, employee resource groups, and corporate citizenship demonstrate our commitment to inclusion and diversity throughout our system.

Why do we embrace inclusion and diversity? For the Love of Health.

Our Values

We serve together in Love and Excellence. Our unique values, Love and Excellence are bold and powerful, and they are the reason why working for ChristianaCare is special. The behaviors associated with our values guide how caregivers interact with everyone they work with and make for an exceptional work experience. We believe that when you lead with Love, Excellence is inevitable.

Benefits

ChristianaCare’s comprehensive total rewards package is one of the most competitive in the region. We are proud to offer excellent benefits that reflect the organization’s commitment to being exceptional today and even better tomorrow.

At ChristianaCare, we provide access to high-quality and affordable benefits designed to meet our caregivers where they are. You can tailor your benefits to meet your needs now and adjust them as your priorities change.

Take advantage of ChristianaCare’s wide-ranging benefit offerings from supporting optimal health through medical, prescription, dental and vision coverage to valuable wellness and work/life programs, which include paid parental leave, coverage for infertility and assisted reproductive technologies, an employer-funded short-term disability program, and more.

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Our region offers a diversity of cultures, lifestyles, sports and entertainment events, housing options and educational opportunities. Located on the I-95 corridor between Philadelphia and Washington, D.C., our location provides easy access to two international airports, employment opportunities in a tri-state area, and proximity to some of the nation's top universities and colleges, as well as beaches in MD, DE and NJ!

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We Serve Together

For the Love of Health

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