Pre Services Representative

Responsibilities

• Perform insurance authorization for elective outpatient radiology imaging and cardiovascular testing
• Schedule, reschedule, and cancel appointments using Schapptbook according to program logic and guidelines
• Verify insurance benefits and approvals for outpatient imaging, elective procedures, surgical cases, and urgent/emergent admissions
• Notify payers of patient admissions or observation status as required
• Manage incoming faxes via the Work Queue Monitor Program
• Communicate with patients, providers, payers, and business partners via Message Center, email, and phone to ensure accurate scheduling and billing
• Research and respond to requests regarding the cost of care

Requirements

• High school diploma or equivalent (GED)
• Minimum of three years of experience in a healthcare or related environment
• Proven expertise in insurance policies, coverage, medical necessity, and prior authorization requirements
• Working knowledge of medical terminology
• Proficiency in Microsoft Office applications and navigating Windows-based environments
• Strong communication, critical thinking, problem-solving, and interpersonal skills
• Ability to work effectively both independently and as part of a large team

About the Company

Concord Hospital is a nationally-accredited, progressive regional health system. Evolving from a community hospital into a $550 million regional integrated health system, we employ over 3,500 talented professionals dedicated to our community mission. We are recognized for sophisticated clinical practices and are the first healthcare system in New Hampshire to be certified in compliance with internationally recognized ISO 9001 quality management practices.