Insurance Specialist Full Time

About the role

Treating patients like family
Community Hospital North is hiring a Full Time Insurance Specialist with a $500 Sign On Bonus!

Essential Functions

• Notify Case Management daily of all inpatient and observation patient admissions to ensure communication to insurance companies of patient’s status.
• Accurately obtain via fax, telephone or personal interview, the required financial and insurance information from the patient, patient’s representative, scheduling or physician’s office.
• Verify and obtain insurance coverage and benefits via insurance company website, insurance eligibility programs or by telephone for all patients registered for services for all payer types.
• Perform notifications and obtain pre-authorizations and/or per-certifications for timely and accurate reimbursement.
• Determine appropriate financial class and accurately enter the data into the system.
• Communicate insurance coverage details to patients and inform the patient/guarantor prior to service date regarding payment expectations related to co-payments, co-insurance, and/or deductible amounts.
• Notify patients of any required and expected co-pay’s, deductibles or co-insurance payments prior to their arrival.
• Attempt to collect patient payments during initial phone contact in order to alleviate the amount of effort and time required on the day of service.
• Log cash collections, generate receipts and maintain a balanced cash drawer at all times. Post payments to patient’s account as required.
• Document in the patients account notes any information that will assist the business office in their efforts to understand the issues that may impact efficient billing, questions about the status of the claim or other follow-up.
• Provide assistance to patients when they present to the facility in person with questions regarding billing or open accounts.
• Inform Department Director or Team Lead of potential problem accounts or additional requirements for reimbursement to receive direction on how to resolve situations.
• Consistently demonstrate premier customer service and communication skills with all internal and external customers/contacts and ensure the patient and their family members have the best hospital encounter possible.
• Consistently respond to all incoming calls within the third ring.
• Maintain operational knowledge of all insurance requirements necessary to achieve optimal reimbursement.

Qualifications

• High School graduate or equivalent required; 2 years college preferred.
• Experience in patient registration, verification and authorization in a medical center or comparable required.
• Working knowledge of managed care, Medicare, worker’s compensation, indemnity and other third party payers required.
• Working knowledge of governmental regulations and other reimbursement criteria required.
• Ability to accurately type 40 WPM, complete forms, simple correspondence and enter data.
• Excellent verbal and written communication as well as interpersonal skills required.
• Demonstrated ability to handle multiple tasks with short time-lines, prioritize and organize work, and complete assignments in a timely and accurate manner.
• Exceptional ability to interact and communicate effectively, tactfully, and diplomatically with patients, families, medical staff, co-workers, employers and insurance company representatives.
• Must have a pleasant disposition, positive attitude and possess the ability to maintain a cordial and professional approach during periods of stress.
• Skill in using office equipment: basic computer skills, photocopier, telephone, fax machine, and calculator.
• Demonstrated ability to think and act decisively in a timely manner.