About the Client: OpenLoop was founded with the mission to expand access to care for patients across the country by bringing healthcare into the home. What truly sets their team apart is the level of quality, care, and compassion they pour into supporting their digital health clients wherever they need assistance the most. It's safe to say, they are as passionate about providing superior virtual care as they are… and it shows!
Job Summary:
The Patient Engagement Specialist plays a crucial role in providing exceptional patient experiences by efficiently managing patient registration, patient financial services, insurance verification, and pre-authorization processes. This position requires excellent attention to detail, strong communication skills, and the ability to collaborate effectively with both patients and internal departments. The Patient Engagement Specialist ensures a smooth and seamless registration process while maximizing patient satisfaction. Responsibilities:
Patient Registration: Accurately collect and enter patient information into the system.
Verify patient demographics, insurance coverage, and eligibility.
Ensure compliance with registration policies and procedures.
Provide excellent customer service to patients during the registration process.
Collaborate with other departments to resolve any registration-related issues.
Patient Payments and Collections: Collect patient copayments, coinsurance, and deductibles at the time of service or through follow-up communications.
Send out monthly statements to patients, detailing their outstanding balances and payment options.
Conduct patient collection calls to remind and assist patients in resolving their financial obligations.
Assist patients in setting up payment plans and provide guidance on available payment methods.
Ensure patient payment information is securely processed through systems like Stripe.
Maintain accurate and up-to-date records of patient payments and collections.
Eligibility Verification: Verify insurance coverage and benefits for patients.
Ensure accurate and complete eligibility verification.
Identify any pre-authorization requirements and assist in obtaining them.
Communicate insurance-related information to patients and other departments.
Work closely with insurance companies to resolve eligibility issues or discrepancies.
Pre-Authorization Management: Review medical documentation and treatment plans to determine pre-authorization requirements.
Submit pre-authorization requests to insurance companies.
Follow up on pending or denied pre-authorizations and work to resolve them.
Maintain accurate records of pre-authorization status and documentation.
Collaborate with healthcare providers and insurance companies to ensure timely approvals.
Patient Communication and Support: Serve as a point of contact for patients regarding registration, insurance, and pre-authorization inquiries.
Provide clear and concise explanations of processes, requirements, and next steps to patients.
Address patient concerns, questions, and complaints promptly and professionally.
Collaborate with other departments to ensure coordinated and efficient patient care.
Process Improvement: Identify opportunities to streamline and enhance patient engagement processes.
Propose and implement improvements to optimize registration, insurance verification, and pre-authorization workflows.
Collaborate with cross-functional teams to enhance the overall patient experience.
Requirements High school diploma or equivalent; additional healthcare-related certifications or education is a plus.
2-3 years of previous experience in patient registration, eligibility verification, or pre-authorization. Knowledge of medical terminology, insurance plans, and billing processes. Strong communication and interpersonal skills.
Attention to detail and accuracy in data entry and documentation.
Ability to handle confidential patient information with discretion.
Proficient computer skills, including experience with electronic medical records and registration systems.
Ability to work independently and collaboratively in a fast-paced environment.
Must have Fiber Optic internet with at least 25 Mbps bandwidth
Must have a backup desktop or laptop with the latest OS
Must be able to work followingUS CST Shifting Must be amenable to reporting to our BGC office 4x a week Benefits WHAT WE OFFER:
Great Place to Work-Certified Company
Premium HMO
Holistic employee experience
Work-from-home and hybrid work setup
Rewards and incentives
Monthly engagement activities
Career advancement opportunities
Paid referral program
