PA, Pre-Services Specialist

Welcome to Ovation Healthcare! 

At Ovation Healthcare, we’ve been making local healthcare better for more than 40 years. Our mission is to strengthen independent community healthcare. We provide independent hospitals and health systems with the support, guidance and tech-enabled shared services needed to remain strong and viable. With a strong sense of purpose and commitment to operating excellence, we help rural healthcare providers fulfill their missions. 

The Ovation Healthcare difference is the extraordinary combination of operations experience and consulting guidance that fulfills our mission of creating a sustainable future for healthcare organizations. Ovation Healthcare's vision is to be a dynamic, integrated professional services company delivering innovative and executable solutions through experience and thought leadership, while valuing trust, respect, and customer focused behavior. 

We’re looking for talented, motivated professionals with a desire to help independent hospitals thrive. Working with Ovation Healthcare you will have the opportunity to collaborate with highly skilled subject matter specialists and operations executives, in a collegial atmosphere of professionalism and teamwork. 

Ovation Healthcare's corporate headquarters is located in Brentwood, TN. For more information, visit https://ovationhc.com. 

Summary: 

The Patient Access Pre-Services Specialist is responsible for ensuring a smooth and efficient pre-registration and pre-authorization process for patients prior to their scheduled medical procedures or appointments. This role involves verifying patient demographics, verifying insurance coverage, verifying necessary authorizations, communicating with patients regarding financial responsibilities, and coordinating with clinical and administrative teams to ensure seamless patient access to care. 

 
Duties and Responsibilities: 

• Collect and verify patient demographics and insurance details. 

• Ensure accuracy of patient data in the hospital's electronic health record (EHR) system. 

• Verify accuracy physician orders and facility guidelines. 

• Confirm insurance eligibility and benefits before services are rendered. 

• Confirm prior authorizations for procedures, and diagnostic tests, as required by insurance providers. 

• Communicate with insurance companies to resolve coverage issues and prevent delays in care. 

• Notify patients of their financial responsibilities, including co-pays, deductibles, and out-of-pocket costs. 

• Provide information on payment options, financial assistance, and insurance coverage. 

• Address patient non-clinical questions and concerns regarding their upcoming visit. 

• Work closely with clinical staff, billing departments, and insurance representatives to ensure all necessary documentation is completed. 

• Follow up on pending insurance approvals and escalate urgent cases as needed 

Knowledge, Skills and Abilities:  

• Strong knowledge of medical terminology, insurance policies, and healthcare billing practices. 

• Excellent communication and customer service skills. 

• Ability to handle confidential patient information with discretion. 

• Proficiency in EHR systems and scheduling software. 

• Detail-oriented with strong organizational and multitasking abilities. 

Work Experience, Education, and Certifications:  

• High school diploma or equivalent required; Associate’s degree in healthcare administration or a related field preferred. 

• Experience in patient access, insurance verification, medical billing, or a related healthcare role is highly desirable.