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About the Role

Obtains and/or verifies demographic, clinical, financial, and insurance information for patient appointments, pre-registration, and financial clearance. Validates medical necessity for Medicare and Non-Medicare cases, obtains physician orders, and conducts insurance eligibility/benefit verification. Collects patient liabilities and refers cases for follow-up as needed.

Responsibilities

• Receive orders and schedule outpatient appointments for all modalities except biopsy and special procedures and all radiology outpatient facilities.
• Determine proper scheduling requirements and/or limitations according to requested tests/procedures and schedule resources (equipment, staff, room, etc.).
• Coordinate add-on and same-day appointments.
• Ensure proper test sequencing with minimal patient delays when multiple testing is required.
• Perform insurance eligibility/benefit verification using various mechanisms and document information within the appropriate registration system.
• Pre-register patients for upcoming visits.
• Call patients to remind them of appointment details, inform them of financial responsibility, answer questions, and provide directions.
• Validate medical necessity (LMRP/LCD review) of Medicare and Non-Medicare cases to ensure clinical and financial clearance.
• Inform patients/guarantors of their liabilities and collect appropriate patient payments at the point of pre-registration.
• Provide patient, family, and physician office education during the scheduling process regarding preparations and scheduling instructions.
• Send and/or communicate appointment confirmation to the referring office.
• Reconcile charge reports daily and communicate errors to staff.
• Perform other duties as assigned.

Requirements

• High school diploma or equivalent required.
• College courses in Business or Health Care Administration and/or Computer Technology preferred.
• Medical terminology required within one year of employment.
• 1 year insurance/clerical experience within a hospital or medical office setting preferred.
• Proficiency in reading, writing, and speaking the English language.
• Must pass pre-employment testing and post-training testing.
• Must have knowledge of insurance and collection of payments.
• Must have experience with Microsoft software.
• Must possess excellent verbal and written communication skills, customer service skills, and problem-solving abilities.
• Must be multi-skilled with the ability to appropriately handle complexity and stress with the changing needs of patients, families, visitors, and the Health System.
• May be required to periodically rotate shifts and regular days off.
• All system employees must have the flexibility to meet the department hours of operation.
• Must be able to communicate orally, see, and hear to collect information.
• Must have dexterity to operate office equipment.
• Answers telephone calls, uses personal computer and other business machines extensively.
• Bends, reaches, pushes, and pulls file drawers to file records and reports.
• Regularly lift or move up to 10 pounds, frequently lift or move up to 25 pounds, and occasionally lift or move up to 50 pounds.

Skills

• Microsoft software proficiency
• Verbal communication skills
• Written communication skills
• Customer service skills
• Problem-solving abilities
• Medical terminology

Location

• Fayetteville, North Carolina

Work Type

• Days

Experience Level

• 1 year insurance/clerical experience preferred

Education Level

• High school diploma or equivalent
• College courses in Business or Health Care Administration and/or Computer Technology preferred

About the Company

• Cape Fear Valley Health System

Equal Opportunity

• Cape Fear Valley Health System is an Equal Opportunity Employer M/F/Disability/Veteran/Sexual Orientation/Gender Identity