Pre Service Specialist 1 at Nuvance Health in Danbury, Connecticut

Job Description:

Health Quest and Western Connecticut Health Network have combined to form a new nonprofit health system. The name for the new health system will be Nuvance Health. The new health system was created to provide communities across New York’s Hudson Valley and western Connecticut with more convenient, accessible and affordable care.

Nuvance Health has a network of convenient hospital and outpatient locations — Danbury Hospital, New Milford Hospital, Norwalk Hospital and Sharon Hospital in Connecticut, and Northern Dutchess Hospital, Putnam Hospital Center and Vassar Brothers Medical Center in New York — plus multiple primary and specialty care physician practices locations.

Summary:
Facilitates patient flow through the referral, scheduling, and financial clearance process. Responsible for obtaining demographic and financial information to ensure accurate patient identification and to secure reimbursement. Performs pre-registration functions and insurance eligibility verification. Provides estimates for services. Requests and secures payments

 

Responsibilities:

• May be assigned to schedule patients for hospital or medical group services by incoming phone calls, online requests, or outbound to patients.


• Work within the central referral management system to identify and schedule specialist and primary care referrals.


• Provides excellent customer service both to physician offices and patients.


• Performs insurance eligibility verification and executes payer requirements as needed.


• Obtains accurate insurance benefit information from payers, such as deductible, copay, and coinsurance amounts.


• Utilizes patient estimation tool to calculate estimate of patient liabilities.


• Initiates requests for authorizations, pre-certifications, notices of admission, and referrals from insurance companies.


• Follows up with payers and providers to ensure that authorizations are in place.


• Collects on such liabilities prior to time of service utilizing provided scripting.


• Refers patients who express financial hardship to Financial Counseling for a financial assessment.

Requirements:

• HS Diploma


• Required Minimum of 2-year job-related experience


• Associates Degree Preferred with 6 months job-related experience 


• National Association of Healthcare Access Management (NAHAM) certification within one year of hire

Location: Summit-100 Reserve Rd

Work Type: Full-Time

Standard Hours: 40.00

Work Shift: Variable hours Mon-Fri 8am - 8pm

Department: Corporate Financial Clearance

Salary Range: $15.30 - $28.22 Hourly (based upon experience)

 

 

 

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