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Pre-Arrival Rep, RCM

Expired Job

BJC Healthcare St. Louis , MO 63110

Posted 3 months ago

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.
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

High School Diploma or GED

2-5 years

Preferred Requirements and Additional Job Information

Licenses & Certifications

Service Support Skills
Patient Access

  • 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

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Pre-Arrival Rep, RCM

Expired Job

BJC Healthcare