See all jobs in Doral FL
Job Location: Doral, FL
Type: Full Time Employee
# of Openings: 1
SCA, a leader in the outpatient surgery industry, strategically partners with health plans, medical groups and health systems across the country to develop and optimize surgical facilities. SCA operates more than 210 surgical facilities, including ambulatory surgery centers and surgical hospitals, in partnership with approximately 7,500 physicians. For more information on SCA, visit www.scasurgery.com.
Accountabilities / Responsibilities
Provide support to the facility by performing specific or various business office functions as assigned. These functions are to include (but not limited to): Insurance Verification, Accounts Payable, Medical Records, Credentialing, Admissions/Intake, , Billing, Collections, Transaction, Posting, Clinical Logs and other duties as assigned.
- Verify that sufficient information is available for accurate verification and eligibility. This step may require direct contact with the physician office and/or the patient.
- Determine if a secondary insurance should be added to the patient account ensuring the appropriate payer is selected for Primary insurance.
- Utilize the centers selected vendor for claims and eligibility and/or individual payer websites to obtain eligibility, benefits and/or pre-certs and authorization information.
- Enter the patient insurance information into patient accounting system ensuring the selection is the appropriate payer and associated financial class.
- Answers phone in a pleasant manner and deals with physician offices and patient's needs expeditiously. Takes messages and transfers calls to other departments when necessary.
- SCA's goal for each patient's insurance verification is complete and accurate. Will document the findings in the patient account and will contact the patient with either estimated co-insurance, co-pay and or deductible amounts due on or before the date of service as applicable
- Does pre-registration and makes sure that authorization is obtained from the physician's office prior to surgery scheduled. Completes necessary paperwork for registration and uses computer system to generate information for surgical/special procedure.
- Obtain authorizations from insurance companies/physician offices. Ensure complete and accurate information is entered into the patient accounting system and the procedure scheduled, date of service and facility name are on the authorization. Ensure the authorization has not expired.
- Check insurance company approved procedure lists/medical policies. If procedure is not payable, notify patient. If patient wants to proceed, obtain signature on Medicare ABN or other non-covered notification form.
- Patients with a financial responsibility are contacted immediately and informed of the center's payment policies as well as offered payment options if necessary.
- Be familiar with individual payer guidelines and the process of collecting over the counter payments/deductibles/copay/co-insurance. Knowledge of payer contracts including Medicare, Medicaid and other government contracts and guidelines and workmen's compensation fee schedule.
- Schedules surgeries in surgery template in the computer, along with pertinent information and handles calls from physician's office in regard to information on scheduling patients at the surgery center, scheduling surgeries or any calls associated with surgery scheduled.
- Performs various clerical duties such as photocopying forms, reports, patient information, mailing surveys, preparing patient charts, faxing forms and retrieving faxes as needed.
- Bachelor's degree preferred but not required
- Strong customer service experience
- A/R, billing, insurance verification or customer service experience preferred
- Healthcare experience a must
- The successful candidate must have the ability to work independently as well as function within a team
- Have a basic knowledge of surgery scheduling, receptionist and registration responsibilities; and must possess the ability to handle stress.
We value Diversity, Inclusion, and Belonging at Surgical Care Affiliates: SCA is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), age, national origin, disability and genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.