Pre-Clearance Coordinator

Description

Responsible for reviewing physician orders for accuracy, obtaining necessary insurance authorizations and pre- registering patients prior to tests and procedures. The Pre-Clearance Coordinator will obtain or verify individual identifying and demographic data for the patient’s permanent medical record. The Pre-Clearance Coordinator will determine patient benefits and eligibility and advise and collect from patient all applicable estimated costs prior to procedure.

Functions of the Position (not an exhaustive list):

• Review incoming orders for accuracy and compliance with insurance and Dosher guidelines
• Perform eligibility and benefits check to accurately verify patient’s active coverage and determine potential costs and authorization needs associated with patient’s treatment
• Obtain or verify necessary prior authorizations are on file for tests/procedures
• Register patients efficiently and accurately by obtaining signatures, complete all required forms and provide patient’s information as required by state and federal regulations
• Communicate estimated financial obligations with patient prior to procedure and collect applicable monies due prior to procedure or coordinate payment arrangements

Requirements

Qualifications

Education:

• High school graduate or equivalent
• Medical office or Hospital experience required =

Necessary skills:

• Ability to comprehend and follow instructions
• Familiarity with Regulatory Standards
• Maintain strictest confidentiality and adhere to all HIPAA guidelines/regulations
• Ability for rapid mental/muscular coordination simultaneously
• Ability to perform in emergency situations
• Knowledge of basic medical terminology

Physical Demands:

• Requires sitting for long periods, sometimes in a confined space
• Lifting/carry up to 30 lbs
• Repetitive finger movement
• Repetitive twisting and pressure involving hand and finger mobility
• Reaching at all levels
• Stooping, bending, kneeling, or crouching
• Possible exposure to bloodborne pathogens
• Work with machinery with moving parts

Protective Equipment Required:

• PPE as required