Employment Type:

　　Part time

　　Shift:

　　Day Shift

　　Description:

　　Position Purpose:

　　Saint Alphonsus Health System is hiring a PreService Specialist to support the Financial Clearance Team. The Pre-Service Specialist obtains and/or verifies demographic, clinical, financial and insurance information in the process of pre-registering and financially clearing patients for service delivery, including the entry of patient/guarantor information in the patient accounting system. The Pre-Service Specialist is also responsible for insurance eligibility/benefit verification, pre-certification/authorization, referral clearance and financial education on designated cases.

　　Our ideal candidate will be local to the Treasure Valley in Idaho.

　　Position Highlights and Benefits:

　　Schedule Information: This position will be scheduled on an as needed basis according to business needs. Anticipated need is 20 hours a week, however, h ours may vary significantly. An ideal candidate will have the flexibility to work as needed on day shift Monday through Friday.

　　Position is remote (work from home), however, there is required in-person training during initial orientation in Boise, ID.

　　Minimum Qualifications:

　　High school diploma or equivalent required.

　　Associate degree or an equivalent combination of education and experience preferred but not required. Data entry skills (50-60 keystrokes per minute).

　　Past work experience of at least 2 years within healthcare and/or payer environment performing patient access and/or customer service activities is highly desired but not required.

　　What You Will Do:

　　Work concurrently on a variety of tasks/projects in an environment that may be stressful with individuals having diverse personalities and work styles. Excellent problem-solving skills are essential.

　　Ensures patient safety by authenticating patient identity throughout all essential functions.

　　Meets or exceeds established customer service, productivity and quality standards in all essential functions.

　　Maintains a working knowledge of applicable Federal, State, and local laws and regulations, Trinity Health’s Organizational Integrity Program, Standards of Conduct, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical, and professional behavior.

　　Performs activities that relate to pre-registration and financial clearance for multiple patient types (Inpatient Admissions, Outpatient Observation and Bedded Outpatients, Diagnostic Outpatients, Ambulatory Surgery, Series accounts, etc.), and support coverage of other departmental divisions. Frequent communications will occur with patients/family members/guarantors, and physicians/office staff in the deployment of key activities.

　　Responsible for pre-registering the patient for upcoming visit(s) by interviewing the patient, family member and/or guarantor. Validates, obtains and enters demographic, clinical, financial, and insurance information into the patient accounting system. Utilizes multiple modes of communication (phone, fax, patient portal/e-mail, mail, etc.) and in a professional, accurate, efficient and courteous manner to obtain information and ensure good patient relations and a smooth billing process. During pre-registration calls, the position will provide information regarding directions, parking, transportation service, overnight accommodations, etc. Pre-Registration may be initiated by Scheduling staff with follow-up by the Pre-Service Specialist to ensure data integrity and completeness.

　　Performs insurance eligibility/benefit verification, utilizing a variety of mechanisms (primarily EDI transactions and payer web access, and in some cases by calling payers directly) and documenting information within the patient accounting system. Outcomes of the insurance eligibility/benefit verification activity will determine next steps (designation as a Self-Pay account, referral to financial counseling, etc.).

　　Determines need for appropriate service authorizations (pre-certifications, third-party authorizations, referrals) and will contact the physician and Case Management/Utilization Review personnel, as necessary.

　　Informs patient/guarantor of their liabilities and collects appropriate patient liabilities, including co-payments, co-insurances, deductibles, deposits and outstanding balances at the point of pre-registration. Calculates patient liabilities and provides financial education, referring the patient to financial counseling, as required. Documents payments/actions in the patient accounting system and provides the patient with a payment receipt in the collection of funds.

　　Validates medical necessity (LCD/NCD review) of Medicare and Non-Medicare cases to ensure clinical and financial clearance. Contacts scheduling and/or ancillary department staff for clarification, if cases require clarification of diagnosis and/or test(s)/procedure(s).

　　May serve as relief support, if the work schedule or work-load demands assistance to departmental personnel. May also be chosen to serve as a resource to train new employees. Cross- training in various functions is expected to assist in the smooth delivery of departmental services.

　　Other duties as needed and assigned by the Manager/Supervisor.

　　Position operates in an office environment. Work area is well-lit, temperature controlled and free from hazards . Occupational exposure to blood or other potentially infectious materials may reasonably be anticipated from the performance of the employee's duties. Skin, eye, mucous membrane, and/or parenteral contact with blood or potentially infectious material is reasonably anticipated . The incumbent is subject to eye-strain due to the many hours spent looking at a CRT screen. The noise level is moderate to high.

　　Work is performed in a contained area. Must be able to sit or stand for extended periods of time and use a telephone headset.

　　Completion of regulatory/mandatory certifications and skills validation competencies preferred

　　Working knowledge of medical terminology desirable. Basic computer skills are required.

　　Excellent communication (verbal and written) and organizational abilities. Interpersonal skills are necessary in dealing with internal and external customers, including the ability to interpret customer requirements, recommend and take action to satisfy the customer’s needs. Accuracy, attentiveness to detail and time management skills are required.

　　Must be comfortable operating in a collaborative, shared leadership environment.

　　Must possess a personal presence that is characterized by a sense of honesty, integrity, and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals, and values of Trinity Health.

　　Highlights and Benefits:

　　When Saint Alphonsus takes care of you, you can take better care of our patients. We foster personal and professional growth and offer opportunities that empower our colleagues to develop their careers. Our belief in work-life balance compliments the natural beauty, diverse landscapes, and outdoor recreation lifestyle that is unique to Idaho and Oregon.

　　We offer market-competitive pay, generous PTO, and multiple options for comprehensive benefits that begin on day one.

　　Benefits for your future include retirement planning and matching, college savings plans for your family, and multiple life insurance plans that can change as your needs develop.

　　We are proud to offer Employee Assistance Programs, tuition reimbursement, and educational opportunities to help you learn and grow.

　　Visit www.saintalphonsus.org/careers (https://www.saintalphonsus.org/careers/search-openings/details?j=00137722_Speech%20Therapist%20PRN) to learn more!

　　Ministry/Facility Information:

　　Saint Alphonsus Health System is a faith-based ministry and not-for-profit health system serving Idaho, Oregon, and northern Nevada communities. The health system boasts 4 hospitals, 609 licensed beds, and 73 clinic locations. Through innovative technologies, compassionate staff, and healing environments, Saint Alphonsus' goal is to improve the health and well-being of people by emphasizing care that is patient-centered, physician-led, innovative, and community-based.

　　Top 15 Health Systems in the country by IBM Watson Health;

　　The region’s most advanced Trauma Center (Level II);

　　Commission on Cancer Accredited Program through demonstrating an uncompromising commitment to improving patient survival and quality of life.

　　Our Commitment to Diversity and Inclusion

　　Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.

　　Our Commitment to Diversity and Inclusion

　　Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.

　　Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity.

　　EOE including disability/veteran