This network-wide position, under the direction of the Pre-Access Manager, Kettering Health, is responsible to facilitate the patient intake process by obtaining and validating precertification’s on scheduled outpatient services, sleep studies, radiation oncology, elective scheduled surgeries and/or additional services as needed. The Representative reviews insurance verification and obtains/validates precertification information when required at each encounter to ensure accurate and complete billing. This highly visible position must be aware of the importance and impact this position has on KH denial and public relations. The representative provides exceptional customer service to our patients, providers and all other departments and is always expected and required to be exhibited
1. Demonstrates through behavior Kettering Health’s mission, vision and services standards as outlined in the organization’s training.
2. Maintain competence and use critical thinking skills to promptly resolve consumer inquires within assigned functional area(s).
3. Demonstrates successfully to resolve customer inquiries
4. Adhere to all established workflows, scripting, and department greetings
5. Create delightful customer experience by setting proper expectations and consistently following through with end- users
6. Documents all interactions and consistently update consumer records in the relevant technology system(s)
7. Demonstrates appropriate customer-care skills such as empathy, active listening, courtesy, politeness, helpfulness and other skills as identified to a variety of customers including consumers, clinic staff, physicians, Pre-Access colleagues, and leaders
8. Achieves individual key department performance objectives such as quality assurance and productivity.
9. Maintain knowledge of Pre-Access and Kettering Health offerings to provide exceptional services
10. Handle sensitive matters courteously and with professionalism. When appropriate, escalate with leadership for proper awareness and/or resolution.
11. Adhere to department policies and procedures and HIPAA regulations
12. Perform other duties as assigned by department leaders
Kettering Health is a not-for-profit system of 14 medical centers and more than 120 outpatient facilities serving southwest Ohio. Our mission is to live God’s love by promoting and restoring health. Our commitment to our patients is to help individuals be their best. With that context, safety is our top priority. We provide an integrated system of healthcare experts committed to providing exceptional care.