RMA - PAC (CLEARLAKE REMOTE)

Centauri Health Solutions - Houston, TX

Full-time - Entry Level

Houston, TX

1,001-5,000 employees

Professional, Scientific, and Technical Services

About the position

The RMA - PAC position at Centauri Health Solutions is responsible for performing Schedule+® functions for physicians and patients, focusing on insurance verification and pre-certification for scheduled services at HCA facilities. The role emphasizes quality customer service and effective communication with patients, physicians, and co-workers, ensuring a smooth scheduling process and compliance with regulatory requirements.

Responsibilities

• Thoroughly completes the insurance verification process to ensure the accuracy of insurance information.
• Obtains insurance authorizations, referrals, and treatment consults as needed for all scheduled patients prior to receiving services.
• Coordinates peer-to-peer reviews as needed between the physician and the insurance company.
• Obtains benefit coverage from insurance companies and accurately enters information into the appropriate computer system.
• Obtains diagnosis information and/or CPT code from the physician/office or the outpatient department, as necessary for completing the insurance authorization process.
• Maintains proficiency in the various systems utilized during insurance verification and authorization process including various online payor eligibility programs.
• Monitors appropriate work lists to ensure timely insurance verification processing.
• Maintains documentation necessary for compliance with state, federal, and other regulatory agency requirements.
• Makes outbound and receives inbound calls to schedule patients for imaging services at an HCA facility.
• Schedules and documents notes in hospital and Centauri's operating system.
• Provides patient prep instructions for the services scheduled.
• Works with hospital staff to ensure patients are scheduled timely, appropriately and receive the utmost customer service.
• Monitors and manages the e-mail inbox or fax machine for assigned practices throughout the day.
• Works any requests e-mailed or faxes received.
• Checks and responds to voicemails.
• Creates, maintains and monitors log of patients and procedures scheduled for assigned physician practices.
• Identifies and recommends process improvements for the Schedule+ Program.
• Performs other duties as assigned by the Patient Access Management Team.

Requirements

• Excellent customer service or client relations experience; office or hospital environment.
• High volume call center experience preferred.
• High school diploma or equivalent GED required.
• Associates degree in a related field or a minimum of two years in patient scheduling, registration and/or healthcare billing.
• Strong Literacy (grammar, spelling, math).
• Strong Microsoft Products, word, excel, outlook, windows.

Benefits

• Competitive compensation
• Generous paid time off
• Matching 401(k) program
• Tuition reimbursement
• Annual salary reviews
• Comprehensive health plan
• Opportunity to participate in volunteer activities on company time
• Development opportunities
• Bonus eligibility in accordance with the terms of the Company's plan.