[Close] 

Pre-Arrival Rep RCM


Employment Status: Full-Time
Your Career. Made Better.

BJC HealthCare is one of the largest nonprofit health care organizations in the United States, delivering services to residents primarily in the greater St. Louis, southern Illinois and mid-Missouri regions. BJC serves patients and their families in urban, suburban and rural communities through its 15 hospitals and multiple community health locations. Services include inpatient and outpatient care, primary care, community health and wellness, workplace health, home health, community mental health, rehabilitation, long-term care and hospice.

Join Us!

Role Purpose

To ensure prompt and efficient access to hospital outpatient scheduled services by providing exceptional service to customers during the pre-arrival process. Responsible for completing the necessary data elements in a timely and efficient manner in order to financially clear all patients prior to their scheduled event. Will complete work lists as assigned not only to have acceptable productivity but to do so with quality data entry.

Responsibilities

  • Part of a multi-disciplinary team that supports all aspects around financially clearing patients before their arrival. Members of this team are generally cross-trained into 2 - 5 functions. This team supports mutliple BJC hospital facilites.
  • Pre-Registration: outbound calls to patients to obtain and verify accurate demographic and insurance information (including MSPQ as required). May also include a pre-admit function in which encounters are created prior to phone calls being performed. In both cases, utilizes multiple systems and all available resources to verify insurance information that was not completed during the pre-registration/scheduling process.
  • Perform POS Collection functions (primarily in conjunction with the pre-registation process). Using defined worklists patients are contacted with their estimated financial liability and given the option to make payment over the phone before arriving for service.
  • Reviews providers' orders for key elements and processes/indexes them via an on-line fax program. Orders are compared to the scheduling system and matched with an upcoming patient encounter when appropriate.
  • Authorizations (ancillary and surgery): Contacts provider offices, payors and/or payor websites to secure and validate authorization information. A review of medical records may be required if initiating the authorization request directly with a payor. Follow up on post review of insurance mismatch.
  • Minimum Requirements

    Degree

  • High School Diploma or GED
  • Experience

  • <2 years
  • Preferred Requirements and Additional Job Information

    Experience

  • 2-5 years
  • Licenses & Certifications

  • CHAA
  • Service Support Skills

  • Patient Access - 2 years or more
  • Insurance Verification - 2 years or more
  • Benefits Statement

    Note: not all benefits apply to all openings

    - Comprehensive medical, dental, life insurance, and disability plan options
    - Pension Plan /403(b) Plan
    - 401(k) plan
    - Tuition Assistance
    - Health Care and Dependent Care Reimbursement Accounts
    - On-Site Fitness Center (depending on location)
    - Paid Time Off Program for vacation, holiday and sick time

    Pension does not apply to Memorial Hospital, Memorial Hospital East, Memorial Medical Group, Alton Memorial or Parkland Health Center

    Legal Statement

    The above information on this description has been designed to indicate the general nature and level of work performed by employees in this position. It is not designed to contain or be interpreted as an exhaustive list of all responsibilities, duties and qualifications required of employees assigned to this job.



    Don't Be Fooled

    The fraudster will send a check to the victim who has accepted a job. The check can be for multiple reasons such as signing bonus, supplies, etc. The victim will be instructed to deposit the check and use the money for any of these reasons and then instructed to send the remaining funds to the fraudster. The check will bounce and the victim is left responsible.

    More Jobs

    Registered Nurse (RN) - PACU / Pre Op
    Belton, MO Belton Regional Medical Center
    Marketing & Communications Rep 1 - Water
    Kansas City, MO Black & Veatch
    Communications Rep PRN Hours
    Festus, MO Mercy
    Field Service Rep AVI - Defense 4 (Kuwait City)
    Saint Louis, MO The Boeing Company
    Temporary Certified Classroom Instructor Pre-K...
    Kansas City, MO Kansas City Public Schools