Insurance Verification Representative

Job Summary and Qualifications

The Pre-Registration/Insurance Verifier is responsible for verifying eligibility and benefits of health insurance, government programs and/or workers compensation insurance prior to a patient having an examination. The process also includes verification of the insurance company claims billing address. Must also verify as to whether procedure that has been scheduled requires pre-certification or an authorization number in order to be performed and reimbursed.

Essential Job Functions

• Verifies policy and group number, as well as guarantor and dependents information with insurance company; verifies eligibility and benefits with insurance company; verifies claim mailing address of insurance company.
• Annotates all scheduling changes appropriately in the patient’s history notes.
• Verifies whether pre-certification or pre-authorization is required for exam to be performed and reimbursed.
• Contacts referring physician office if required to obtain additional information regarding exam to send to insurance company for authorization of exam.
• Notifies referring physician office, patient and/or imaging center if exam is not authorized or if exam will not be covered.

Additional Job Functions

• Supports the mission and vision of South Texas Radiology Imaging Centers and demonstrates excellent customer service at all times.
• Understands and is committed to helping South Texas Radiology Imaging Centers and its associated facilities achieve its goals.
• Learns and complies with System and facility safety policies and rules; uses appropriate safety equipment and procedures at all times; reports all unsafe conditions to supervisors; is familiar with all safety features of equipment, tools or materials encompassed by job duties; and checks with supervisors (prior to job performance) if there is a question as to the safe procedure to be used for any job function.
• Adheres to the STRIC Code of Conduct and demonstrates ethical behavior as expected by our patients, colleagues and the community.
• Reports any activity that appears to violate applicable laws, rules and regulations or the Code of Conduct itself.

Minimum Education and Experience

A high school diploma or equivalent is required. Excellent phone etiquette and communication skills are necessary. Proficiency in operating modern telephone, computer and office equipment is required. A working knowledge of medical terminology and health insurance, government programs and worker’s compensation is needed.

Minimum License and Certificates Required

N/A

Benefits

• Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health and telemedicine services.
• Wellbeing support, including free counseling and referral services.
• Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage and leaves of absence.
• Savings and retirement resources, including a 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service), Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support and financial wellbeing counseling.
• Education support through tuition assistance, student loan assistance, certification support, dependent scholarships and a partnership with Galen College of Nursing.

Note

Eligibility for benefits may vary by location. HCA Healthcare has been recognized as one of the World’s Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.