Pre-Arrival Specialist

**Please note:

- Candidates must reside within commuting distance of the Warren Clinic Tower in Tulsa, OK to be considered for this position.

- Onsite training is MANDATORY for the first few months of employment before going remote.

Shift: Monday through Friday, 8:30am - 5:00pm

Job Summary: This position directly impacts the billing and collections functions of the revenue cycle by ensuring accuracy of insurance information and estimate creation. Timely estimate creation and notification is a benefit to the patient and to the organization. Pre-Arrival Specialists do not have any leadership responsibilities, but are expected to perform duties with a high degree of independence, meeting productivity and quality metrics consistently.

Minimum Education: High School diploma or GED

Licensure, Registration and/or Certification: None.

Work Experience: Minimum 1 year experience. 1 year of benefits verification or authorization experience or 2 years of pre-registration experience.  Post-secondary education may be substituted for 1 year of experience.

Knowledge, Skills and Abilities: Basic healthcare and insurance terminology. Basic computer knowledge and skills. Proficient with office machines, including fax, copier and scanner. Good communication skills – written and verbal.  Phone-based contact center skills involving multiple-line phone systems. Ability to navigate insurance websites to access patient, eligibility and payment information. Basic knowledge of medical billing and insurance follow-up activity. Employee must possess the ability to organize and prioritize work; must be detail oriented.

Essential Functions and Responsibilities: Monitors patient work queues to determine encounters that require pre-registration, insurance verification, benefit collection, estimate creation or corrections to ensure proper billing. This process includes, but not limited to, patients scheduled for a test, procedure, surgery or scheduled behavioral health appointment. User works encounters according to assignment and consistently meets daily and weekly productivity goals. Monitors a patient work queues that requires a call to the patient regarding an estimate for an upcoming test, procedure or surgery. Multiple attempts are made to ensure the delivery of information. At the point of contact, collection attempts are made, including notification of prompt pay discount. Additionally, payment plans are initiated if patient indicates inability to pay prior to appointment. User stays logged into the phone que to answer incoming calls. User is to remain “Available” throughout the day to ensure prompt customer service. Accurately monitors, reviews and processes all patients that fall under the No Surprises Act (NSA) requirements for self-pay and out of network insurance plans, including obtaining any single case agreements. Coordinates as needed with other departments regarding financial assistance for patients in need. Documents pertinent information and efforts in computer system based upon department documentation standards. Protects the privacy and security of patient health information to ensure that confidentiality is maintained.

Decision Making: Independent judgment in planning sequence of operations and making minor decisions in a complex technical or professional field.

Working Relationships: Works directly with patients and/or customers. Works with internal and / or external customers via telephone or face to face interaction. Works with other healthcare professionals and staff.

Special Job Dimensions: None.

Supplemental Information: This document generally describes the essential functions of the job and the physical demands required to perform the job.  This compilation of essential functions and physical demands is not all inclusive nor does it prohibit the assignment of additional duties.

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