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Pre-Certification Clerk, FT Days, Eligibility and Financial Clearance

Company: Adventist HealthCare
Location: Gaithersburg
Posted on: January 26, 2023

Job Description:

Adventist HealthCare seeks to hire an experienced Pre-Certification Clerk rep who will embrace our mission to extend God's care through the ministry of physical, mental and spiritual healing.

As a Pre-Certification Clerk rep you will:
--- Confirm coverage requirements for scheduled patients
--- Confirm eligibility for insured patients
--- Obtain needed authorization for service where applicable for insured patients
--- Monitor patient service counts to ensure services are aligned for payments
--- Identify appropriate sources for patients based upon FPL guidelines
--- Appropriately assess ability for payment plans or discount plans
--- Appropriately refer patients to other payment sources (i.e. Medicaid eligibility vendor)
--- Call patients to rescheduled and/or cancel appointments as needed

Qualifications include:
--- High School Diploma or GED required
--- Bilingual Spanish preferred
--- Minimum of 3 years' experience within a healthcare financial environment.
--- Can include insurer or public health setting as well.
--- At least one year establishing eligibility and/or payment authorizations
--- Requires strong knowledge/training in government payor rules and regulations
--- Requires strong knowledge/training regarding TPLs, WC, and other payment

Work Schedule:

Monday - Friday

8:30am - 5pm

At Adventist HealthCare our job is to care for you.

We do this by offering:

  • Work life balance through nonrotating shifts
  • Recognition and rewards for professional expertise
  • 403(b) retirement plan
  • Free Employee parking
  • Benefits Eligible Positions:
    • Competitive, comprehensive benefit plans [including health, employer-paid disability and life insurance, PTO]
    • Employer retirement contribution and match after 1-year of eligible employment with 3 year vesting
    • Ancillary benefits such as flexible spending, legal and pet insurance to meet the needs of employees and their eligible family members
    • Subsidized childcare at participating childcare centers

      As a faith-based organization, with over a century of caring for the communities in the Maryland area, Adventist HealthCare has earned a reputation for high-quality, compassionate care. Adventist HealthCare was the first and is the largest healthcare provider in Montgomery County.

      If you want to make a difference in someone's life every day, consider a position with a team of professionals who are doing just that, making a difference.

      Join the Adventist HealthCare team today, apply now to be considered!

      COVID-19 Vaccination

      Adventist HealthCare requires all applicants to be fully vaccinated for COVID-19 before commencing employment. Applicants may be required to furnish proof of vaccination and , if offered, may elect to be vaccinated at a n designated Adventist HealthCare location.

      Tobacco and Drug Statement

      Tobacco use is a well-recognized preventable cause of death in the United States and an important public health issue. In order to promote and maintain a healthy work environment, Adventist HealthCare will not hire applicants for employment who either state that they are nicotine users or who test positive for nicotine and drug use.

      While some jurisdictions, including Maryland, permit the use of marijuana for medical purposes, marijuana continues to be classified as an illegal drug under the federal Controlled Substances Act. As a result, medical marijuana use will not be accepted as a valid explanation for a positive drug test result.

      Adventist HealthCare will withdraw offers of employment to applicants who test positive for Cotinine (nicotine) and marijuana. Those testing positive are given the opportunity to re-apply in 90 days, if they can truthfully attest that they have not used any nicotine products in the past ninety (90) days and successfully pass follow-up testing.

      Equal Employment Opportunity

      Adventist HealthCare is an Equal Opportunity/Affirmative Action Employer. We are committed to attracting, engaging, and developing the best people to cultivate our mission-centric culture. Our goal is to have a welcoming, equitable, and safe place to work and grow for all employees, no matter their background. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected veteran status.

      Adventist HealthCare will make reasonable accommodations for applicants with disabilities, in accordance with applicable law. Adventist HealthCare is a religious organization as defined under applicable law; however, it will endeavor to provide reasonable accommodations for applicants' religious beliefs.

      Applicants who wish to request accommodations for disabilities or religious belief should contact the Support Center HR Office.

Keywords: Adventist HealthCare, Washington DC , Pre-Certification Clerk, FT Days, Eligibility and Financial Clearance, Accounting, Auditing , Gaithersburg, DC

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