Pre Service Center Verification Specialist

### **Pre Service Center Verification Specialist** * 51115 * Remote, United States * Full Time **POSITION SUMMARY****:** The Pre Service Center (PSC) Verification Specialist role belongs to the Revenue Cycle Patient Access team and is responsible for coordinating all financial clearance activities by navigating all pre\-registration (to include acquiring or validating patient demographic, insurance, and other required elements along with insurance verification activities), obtaining referral authorization, or precertification number(s), pre\-service cash collections. The role ensures timely access to care while maximizing BMC hospital reimbursement. This role requires adherence to quality assurance guidelines as well as established productivity standards to support the work unit’s performance expectations. This position reports to the Pre Service Center Supervisor and requires interaction and collaboration with important stakeholders in the financial clearance process including but not limited to insurance company representatives, patients, physicians, Boston Medical Center (BMC) practice staff, case management and Patient Financial Counseling. This is a Remote Position. **Position: Pre Service Center Verification Specialist** **Department: Ambulatory** **Schedule: Full Time** **ESSENTIAL RESPONSIBILITIES / DUTIES:** * Monitors accounts routed to registration, referral and prior authorization work queues and clears work queues by obtaining all necessary patient and/or payer\-specific financial clearance elements in accordance with established management guidelines. * Maintains knowledge of and complies with insurance companies’ requirements for obtaining prior authorizations/referrals and completes other activities to facilitate all aspects of financial clearance. * Acts as subject matter experts in navigating both the BMC and payer policies to get the appropriate approvals (authorizations, pre\-certs, referrals, for example) for the scheduled care to proceed. The PSC Verification Specialist is an important part of the larger patient care team and helps clinicians understand what payer requirements are necessary for the widest possible patient access to services. * Supports BMC staff at all levels for hands\-on help understanding and navigating financial clearance issues. * Uses appropriate strategies to underscore the most efficient process to obtaining insurance verification, authorizations and referrals, including online databases, electronic correspondence, faxes, and phone calls. * Obtains and clearly documents all referral/prior authorizations for scheduled services prior to admission within the Epic environment. * Works collaboratively with primary care practices, specialty practices, referring physicians, primary care physicians, insurance carriers, patients and any other parties to ensure that required managed care referrals and prior authorizations for specified specialty visits and other services are obtained and appropria