Job Description
Centauri Health Solutions provides technology and technology-enabled services to payors and providers across all healthcare programs, including Medicare, Medicaid, Commercial and Exchange. In partnership with our clients, we improve the lives and health outcomes of the members and patients we touch through compassionate outreach, sophisticated analytics, clinical data exchange capabilities, and data-driven solutions. Our solutions directly address complex problems such as uncompensated care within health systems; appropriate, risk-adjusted revenue for specialized sub-populations; and improve access to and quality of care measurement. Headquartered in Scottsdale, Ariz., Centauri Health Solutions employs 1700 dedicated associates across the country. Centauri has made the prestigious Inc. 5000 list since 2019, as well as the 2020 Deloitte Technology Fast 500™ list of the fastest-growing companies in the U.S. For more information, visit www.centaurihs.com. Role Summary: This position is responsible for accurately performing the Schedule® functions for physicians and patients, including but not limited to insurance verification and pre-certification for all scheduled services at an HCA Facility. Makes and receives phone calls with intent of scheduling services at an HCA facility. This position must demonstrate a commitment of quality customer service to patients, physicians, co-workers and the general public. Remote position, but must live within commuting distance from the Grand Strand Medical Center in Myrtle Beach, SC for occasional visits. Role Responsibilities: Insurance Authorization/Verification • Thoroughly completes the insurance verification process to ensure the accuracy of insurance information. • Obtains insurance authorizations, referral, and treatment consults as needed for all scheduled patients prior to receiving services. • Coordinates peer-to-peer reviews as needed between the physician and the insurance company. • Obtains benefit coverage from insurance companies and accurately enters information into the appropriate computer system. • Obtains diagnosis information and/or CPT code from the physician/office or the outpatient department, as necessary for completing the insurance authorization process. • Maintains proficiency in the various systems utilized during insurance verification and authorization process including various on-line payor eligibility programs. • Monitors appropriate work lists to ensure timely insurance verification processing. • Maintains documentation necessary for compliance with state, federal, and other regulatory agency requirements. • Maintains proficiency in the various systems utilized during insurance verification and authorization process including various on-line payor eligibility programs. Scheduling • Makes outbound and receives inbound calls to schedule patients for imaging services at an HCA facility. • Schedules and documents notes in hospital and Centauri’s operating system • Provide patient prep instructions for the services scheduled • Works with hospital staff to ensure patients are scheduled timely, appropriately and receive the upmost customer service Clerical • Monitors and manages the e-mail inbox or fax machine for assigned practices throughout the day. • Works any requests e-mailed or faxes received • Checks and responds to voicemails • Creates, maintains and monitors log of patients and procedures scheduled for assigned physician practices. • Monitors appropriate work lists to ensure timely insurance verification processing. Additional Responsibilities: • Effectively communicates operational activities and issues with co-workers, Supervisor, and Manager. • Interfaces courteously and effectively with internal and external customers. Must consistently present a positive departmental and organizational image, as well as commitment to departmental goals, objectives, standards, policies and procedures. • Demonstrates proficiency within assigned area of responsibility and a general understanding of the entire Patient Access process. • Identifies and recommends process improvements for the Schedule Program. • Performs other duties as assigned by the Patient Access Management Team. Role Requirements: • Excellent customer service or client relations experience; office or hospital environment • High volume call center experience preferred • High school diploma or equivalent GED required • Associates degree in a related field or a minimum of two years in patient scheduling, registration and/or healthcare billing • Strong Literacy (grammar, spelling, math) • Strong Microsoft Products, word, excel, outlook, windows indeed3 We believe strongly in providing employees a rewarding work environment in which to grow, excel and achieve personal as well as professional goals. We offer our employees competitive compensation and a comprehensive benefits package that includes generous paid time off, a matching 401(k) program, tuition reimbursement, annual salary reviews, a comprehensive health plan, the opportunity to participate in volunteer activities on company time, and development opportunities. This position is bonus eligible in accordance with the terms of the Company’s plan. Centauri currently maintains a policy that requires several in-person and hybrid office workers to be fully vaccinated. New employees in the mentioned categories may require proof of vaccination by their start date. The Company is an equal opportunity employer and will provide reasonable accommodation to those unable to be vaccinated where it is not an undue hardship to the company to do so as provided under federal, state, and local law. Factors which may affect starting pay within this range may include geography/market, skills, education, experience and other qualifications of the successful candidate. This position is bonus eligible in accordance with the terms of the Company’s plan.