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Pre-Admission Representative

AHMC Healthcare

This is a Contract position in Anaheim, CA posted January 14, 2022.

This position requires the full understanding and active participation in fulfilling the mission of AHMC- Anaheim Regional Medical Center and AHMC Inc. It is expected that the employee demonstrate behavior consistent with the core values of AHMC- ARMC and AHMC Inc… The employee shall support AHMC- Anaheim Regional Medical Center’s strategic plan and goals and direction of the performance improvement plan.  The employee will also be expected to support all organizational expectations including, but not limited to;  Customer Service, Patient’s Rights, Confidentiality of Information, Environment of Care and AHMC Inc. initiatives

The Insurance Verifier provides a timely and accurate insurance verification; obtaining current eligibility, benefit coverage and authorizations to provide the necessary data to ensure reimbursement in a timely manner.  This position identifies reimbursement resources for patient care and maximizing the effort to capture it.  Identifies patient responsibilities, insurance reimbursement and other 3rd party reimbursement sources.  Working knowledge of contracts with the ability to interpret per diem rates, case rates, stop loss, resulting in timely and accurate reimbursement. Maintains effective working relations with coworkers, case management, outside companies, and visitors using guest relation techniques while professionally representing the visions and values of AHMC- ARMC.  Works closely with the patient service representatives, reviewing their work for accuracy and assisting them in their duties as needed.

Ability to effectively communicate.

Effective customer service and interpersonal skills.

Computer skills and typing skills required.

Medical terminology preferred.

General knowledge of third party payors, PPO, HMO, POS, EPO, workers compensation, Medicare, Medi-Cal, and Cal-Optima preferred.

Knowledge of insurance authorization/ tracking/ pre-certification preferred.

General knowledge of third party payers.  

Strong organizational skills.

Minimum of 3-5 years admitting/ registration and/or business office background

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