Insurance Verifier (ONSITE POSITION)

Essential Duties And Responsibilities

• Counsels patients regarding patient's financial responsibility to ensure collections of out of pocket payments (i.e, copayments, deductibles, self-pay)
• Conducts insurance verification and authorization validation on scheduled patients to ensure eligibility and that benefits are in order for accurate claim submission and payment
• Utilizes online eligibility verification system and/or may have to contact the Payer directly via telephone and/or access payer website
• Requests pre-authorization/pre-certification for scheduled procedures, urgent procedures and imaging
• Accurately notates the account with actions taken for pre-authorization/pre-certification
• Follows up on pending authorization requests in a timely manner
• Communicates with patient regarding patient’s financial responsibility to ensure collections of out of pocket payments (i.e, copayments, deductibles, self-pay)
• Answers non-medical questions and gives routine non-medical instructions
• Acts as the connection between internal and external customers to assist in the account billing resolution process and to escalate issues which adversely impact claim submission and payment, as directed by supervisor
• Performs independent research prior to seeking management assistance
• Follows department policies and procedures as required to meet payer and regulatory requirements, including procedures related to release of information, record retention, privacy and confidentiality
• Maintains a high level of accuracy in the billing and collection process

Required Skills

• High School diploma or equivalent required
• 1 year in Healthcare Customer Service, Insurance Verification and Billing Systems from a Technical and Functional view (preferred)
• Word, Excel and Outlook experience required
• Ability to learn new programs and systems required
• Ability to read and evaluate Healthcare Receivables Information (required)
• Ability to effectively and correctly communicate to the staff, management and payers