Adventist Health

Faith-based nonprofit integrated health system

Pre-Services Representative

Clinical Support & Patient AdministrationConfirmed live in the last 24 hours

Full-timeRoseville, CA, USAIn-person

About the Job

Requirements

A high school education, General Educational Development (GED) credential, or equivalent is required.
An associate's or technical degree, or an equivalent combination of education and related experience, is preferred.
Healthcare front office experience is preferred.
Customer service experience is preferred.
The associate must receive all required vaccinations as a condition of employment and annually thereafter where applicable.

Responsibilities

Obtain and verify demographic, confidential clinical, and financial information needed to financially secure hospital procedures accurately and efficiently.
Pre-register patients, verify insurance eligibility and benefits, and identify services requiring insurance authorization, notification, or recertification.
Complete medical necessity reviews and determine estimated patient financial responsibility.
Communicate estimated financial responsibility to patients and collect payment.
Follow Joint Commission, Centers for Medicare & Medicaid Services, and Health Insurance Portability and Accountability Act requirements when creating hospital accounts.
Work with nurses, medical staff, ancillary departments, insurance carriers, and other external professionals to help patients obtain healthcare and financial services.
Assist and educate patients throughout the process to provide a positive patient experience.
Complete patient packets with all necessary forms and documents in preparation for admissions.
Coordinate admissions activities to obtain patient information needed for billing and other departments, including medical records.
Discuss, arrange, and receive payment of bills from patients or representatives for copayments and private-pay accounts.
Assist customers with Medicaid and County Medical Services Program applications by evaluating documentation for completeness and accuracy, monitoring compliance with requirements, and establishing appointments with the county welfare office.
Maintain and update patient accounts for medical and financial eligibility and maintain reports related to case qualifications.
Obtain billing, insurance, and other demographic information from patients or representatives.
Obtain necessary authorizations for inpatient stays from utilization review.
Post payments and corresponding contractual adjustments to patient accounts.
Provide the public with insurance information and benefits.
Set up payment schedules when patients or representatives cannot pay balances in full.
Perform other job-related duties as assigned.

Desired Qualifications

An associate's or technical degree, or an equivalent combination of education and related experience.
Healthcare front office experience.
Customer service experience.

Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in Roseville, California, for more than 40 years. In 2019, we unveiled our WELL-certified campus - a rejuvenating place for associates systemwide to collaborate, innovate and connect.

Adventist Health Roseville and shared service teams have access to enjoy a welcoming space designed to promote well-being and inspire your best work.

Job Summary:

Obtains and verifies demographic, confidential clinical and financial information necessary to accurately and efficiently financially secure hospital procedures in a timely fashion. Pre-registers patient, verifies insurance eligibility and benefits, and identifies those services that require an insurance authorization, notification and/or recertification. Completes medical necessity review. Determines estimated financial responsibility. Communicates estimated financial responsibility to patients and collects payment. Adheres to all JCAHO, CMS, and HIPAA requirements when creating a hospital account. Works directly with nurses, medical staff, ancillary departments, insurance carriers, and other external professionals to assist patients with obtaining healthcare and financial services. Assists and educates patients through the process to provide a positive patient experience.

Job Requirements:

Education and Work Experience:

High School Education/GED or equivalent: Required
Associate's/Technical Degree or equivalent combination of education/related experience: Preferred
Healthcare front office experience: Preferred
Customer service experience: Preferred

Essential Functions:

Completes patients packets with all necessary forms and documents in preparation for admissions. Coordinates admissions activities in order to obtain all necessary patient information for billing, but also any needed by other departments such as medical records. Discusses, arranges and receives payment of bills with patient or representative for co-payments and private pay accounts.
Assists customers with Medicaid/County Medical Services Program (CMSP) applications by evaluating documentation for completeness and accuracy, monitoring their compliance with requirements and establishing appointments with county welfare office.
Maintains and updates patients accounts for medical and financial eligibility. Maintains reports related to case qualifications. Obtains all necessary billing, insurance and other demographic information from patient or representative. Obtains necessary authorizations for inpatient stays from utilization review.
Posts payments and corresponding contractual adjustments to patient's accounts. Serves as a resource to public providing insurance information and benefits. Sets up payment schedules if patients or representative are unable to pay balances in full.
Performs other job-related duties as assigned.

Organizational Requirements:

Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply.

Adventist Health participates in E-Verify. Visit https://adventisthealth.org/careers/everify/ for more information about E-Verify. By choosing to apply, you acknowledge that you have accessed and read the E-Verify Participation and Right to Work notices and understand the contents therein.

Pay Range: The estimated base pay for this position is $25.00 to $29.56. Additional individual compensation may be available for this role through differentials, extra shift incentives, bonuses, etc. Base pay is only a portion of the total rewards package, and a comprehensive benefits program is available for qualifying positions. Please contact our Talent Acquisition team for more information.

About the Company

Adventist Health

Faith-based nonprofit integrated health system

Adventist Health is a faith-based nonprofit health system with more than 400 sites of care, including 26 acute care hospitals, primarily on the West Coast and in Hawaii. It provides a full range of health services—from primary and specialty care to hospital-based treatments and wellness programs—delivered across an integrated network of clinics, hospitals, and care facilities. Revenue comes from patient services, insurance reimbursements, and government programs, and earnings are reinvested back into communities to improve health outcomes and expand access to care. The organization differentiates itself through its nonprofit, faith-based model and by reinvesting earnings into community health, along with its broad, integrated network that covers preventive, primary, specialty, and acute care. Its goal is to improve health outcomes for the communities it serves and to expand access to high-quality care.

Company size: 10,001+
Company stage: Grant
Total funding: $210K
Headquarters: Roseville, CA
Founded: Not listed

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