Preadmission Review Assistant

When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives.

Job Type:

Regular

Scheduled Hours:

40

Work Shift:

Day (United States of America)

The Preadmission Assistant's role encompasses all of the various administrative and financial-related tasks necessary to insure payment to the hospital. Preadmission Assistants coordinate the timely admission notification, insurance verification, precertification, and financial counseling of inpatient and selected outpatient activity as it relates to the revenue cycle initiatives, following hospital, departmental, and regulatory policies.

Related tasks are performed as necessary to ensure timely and effective workflow in the department. The highest regard for patient confidentiality is an expectation at all times.

Job Description:

Essential Duties & Responsibilities (including but not limited to):

1.Receives and reviews scheduled cases and ensures that all appropriate demographic and insurance information is captured.

2.Utilizes eligibility capabilities integrated within Epic, as well as payer websites, and provider services lines to verify eligibility and referrals/authorizations for all required cases in a timely and accurate manner.

3.Works collaboratively with the team, physician offices, nursing units, patients, etc., to resolve problems.

4.Estimates hospital charges for elective or urgent self-pay accounts.

5.Explains self-pay responsibilities to patients and their families.

6.Arranges for co-payments, deductibles, and deposits to be documented and collected.

7.Reviews the previous day's admission/observation activity for completeness and accuracy and makes final edits as necessary.

8.Comments account history in Epic when appropriate.

9.Reviews free care guidelines with patients, and refers patients to the Financial Counselors office or Social Services, as appropriate.

10. Involves the manager in problem cases, promptly, providing thorough and specific information.

11. Defers cases with the permission of the manager and the admitting primary care and/or specialty physician as necessary.

12. Acts as a resource to a variety of internal and external clients.

13. Answers inquiries, treat customers with respect and responds promptly.

14. Receives and distributes messages or transfers calls as appropriate.

15. Acts in a way that fosters exceptional interpersonal relations, and represents the hospital in a positive light while providing information to callers.

16. Utilizes the utmost discretion when releasing any information to patients or families. Seeks advice of management when unsure.

17. Adapts to meet constantly changing needs and deliver service that is customer-oriented and cost effective.

18. Keeps abreast of private and government payer rules and regulations.

19. Reads and understands all insurance updates and requirements, and incorporates changes into the workflow.

20. Maintains updated knowledge of hospital and departmental policies and procedures.

21. Performs work responsibilities while staying in compliance with all applicable laws, rules, and regulations. Understands and agrees to uphold the Hospital Compliance Plan.

22. Ability to listen and make changes based on input from Team Lead and Manager.

23. Cross trains and maintains a working knowledge of all preadmission review workflows.

24. Demonstrates initiative and creativity to continuously improve services, departmental and interdepartmental processes, and any other activities that affect quality.

25. Assists with the orientation and training of new staff.

26. Enhances professional growth and development by attending continuing education programs.

27. Attends hospital in-services as required.

28. Assists in the care and maintenance of departmental equipment and supplies, and notifies the manager of any equipment malfunctions or unsafe working conditions.

29. Maintains a safe and secure work environment at all times.

30. Other duties as assigned.

Minimum Qualifications:

1.Bachelor's degree, or equivalent (2 or more years) experience working in a healthcare setting, required.

2.Knowledge of payer rules and regulations, particularly around insurance eligibility, admission/observation notification, and authorization/referral requirements.

3.Basic computer skills, including proficiency in MS Office (Word/Excel/Outlook) applications required.

4.Epic experience preferred.

5.Excellent interpersonal, written, and verbal communication skills to deal professionally, courteously, and tactfully with patients, patient's families, and all levels of hospital staff, as well as a variety of outside business contacts.

6.Strong analytical ability to review and resolve problems successfully.

7.Demonstrated ability to work independently, and pay close attention to detail, for a high level of accuracy nearly 100% of the time.

FLSA Status:

Non-Exempt

As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) and COVID-19 as a condition of employment.