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Keck Medicine of USC

Keck Medicine of USC includes the Keck School of Medicine of USC, the region’s first medical school; the renowned USC Norris Comprehensive Cancer Center, one of the first comprehensive cancer centers established by the National Institutes of Health (NIH) in the United States; the USC Care Medical Group, a medical faculty practice; the Keck Medical Center of USC, which includes two acute care hospitals: 401-licensed bed Keck Hospital of USC and 60-licensed bed USC Norris Cancer Hospital; and USC Verdugo Hills Hospital, a 158-licensed bed community hospital. It also includes more than 40 outpatient facilities, some at affiliated hospitals, in Los Angeles, Orange, Kern, Tulare and Ventura counties.

In 2016, U.S. News & World Report ranked Keck Medical Center of USC among the Top 10 hospitals in the state and among the Top 50 hospitals in the United States in seven specialties: ophthalmology, urology, cancer, geriatrics, orthopedic surgery, nephrology and cardiology and heart surgery.

Financial Clearance Specialist II - Admitting - Full Time 8 Hour Days Shifts

Verdugo Hills Hospital - Admitting Glendale, California

Responsible for obtaining insurance information/verification/authorization to ensure financial clearance of patient accounts. Updates both professional and / or hospital registration systems.
Responsible for completing all registration and insurance fields in both professional and / or hospital registration information systems.
Responsible for calling insurance or using internet portals to obtain and document: a) Insurance eligibility and benefits, b) Financial responsibility, c) Authorization and / or Pre-Certification as required.
Responsible for calculating patient liability on hospital and professional accounts and communicating/collecting the liability from the patient.
Ensure all insurance plans are properly selected in all registration and scheduling information systems.
Responsible for clearing assigned worklists in any of the information systems.
Communicate with physician offices regarding proposed admissions, special procedures, outpatient referrals and same day surgeries.
Responsible for preparing pre-registration on scheduled procedures (i.e. Ancillary, Diagnostic, Surgeries).
Contact patients and / or Physician office as needed for additional information.
Utilize fax applications as appropriate and perform document imaging as required.
Actively obtain written clinical documentation for authorization submissions from Medical/Nursing staff.
Submit pre-certification documentation to third party payers for authorization with correct CPT and ICD coding.
Research payer medical policy requirements for treatment authorizations and understand process for submitting pre-certification requests.
Follow up on outstanding authorization requests and medical documentation requests in a timely manner.
Communication with medical/clinical staff and patients on authorization status/outcome and / or with Director on denied or disputed claims. Scan all authorizations into appropriate system under the respective patient accounts and document authorization outcomes in the registration system.
Perform all other duties as assigned.

REQ20070722 Posted Date: 02/08/2019

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