PTAC Central Unit Representative in Largo, FL at Parallon

Date Posted: 6/11/2018

Job Snapshot

  • Employee Type:
    Full-Time
  • Location:
    Largo, FL
  • Job Type:
    Other
  • Experience:
    Not Specified
  • Date Posted:
    6/11/2018

Job Description

Job Summary – The PTAC Central Unit Representative is responsible for timely and accurate pre-registration and insurance verification. Accurately interprets managed care benefits

 

Duties (included but not limited to):

• Perform pre-registration and insurance verification within 24 hours of receipt of reservation/notification (change to 3-5 days prior to date of service) for both inpatient and outpatient services

• Follow scripted benefits verification and pre-certification format in Meditech custom benefits screen and record benefits and pre-certification information therein

• Contact physician to resolve issues regarding prior authorization or referral forms

• Assign Insurance Plans (IPlan’s) accurately

• Perform electronic eligibility confirmation when applicable and document results

• Research Patient Visit History to ensure compliance with payor specific payment window rules

• Complete Medicare Secondary Payor Questionnaire as applicable for retention in Abstracting module (change to “OnBase”)

• Calculate patient cost share and be prepared to collect via phone or make payment arrangement

• Contact patient via phone (with as much advance notice as possible, preferably 48 hours prior to date of service) to confirm or obtain missing demographic information, quote/collect patient cost share, and instruct patient on where to present at time of appointment

• Receive and record payments from patient for services scheduled.

• Utilize appropriate communication system to facilitate communication with hospital gatekeeper

• Perform insurance verification and pre-certification follow up for prior day’s walk in admissions/registrations and account status changes by assigned facility as per SSC guidelines.

• Communicates with hospital based Case Manager as necessary to ensure prompt resolution of pre- existing, non-covered, and re-certification issues

• Utilize Meditech account notes and Collections System account notes as appropriate to cut and paste benefit and pre-authorization information and to document key information

• Meets/exceeds performance expectations and completes work within the required time frames

• Implements and follows system downtime procedures when necessary

• Practice and adhere to the “Code of Conduct” philosophy and “Mission and Value Statement”

 

Job Requirements

KNOWLEDGE, SKILLS & ABILITIES

• Communication - communicates clearly and concisely, verbally and in writing. This includes utilizing proper punctuation, correct spelling and the ability to transcribe accurately.

• Customer orientation - establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations

• Interpersonal skills - able to work effectively with other employees, patients and external parties

• PC skills - demonstrates proficiency in Microsoft Office applications and others as required

• Policies & Procedures - demonstrates knowledge and understanding of organizational policies, procedures and systems

• Basic skills - demonstrates ability to organize, perform and track multiple tasks accurately in short timeframes, have ability to work quickly and accurately in a fast-paced environment while managing multiple demands, ability to work both independently and collaboratively as a team player, adaptability, analytical and problem solving ability and attention to detail and able to perform basic mathematical calculations, balance and reconcile figures, punctuate properly, spell correctly and transcribe accurately.

EDUCATION

High school diploma or GED required.

EXPERIENCE

One year of related experience required.