Senior Insurance Verification Specialist

About the role

Responsible for collecting and entering complete and accurate demographic and insurance information prior to the patient’s arrival. Verifying that the pre-certification requirements of the insurance companies have been met. Verifying the benefits coverage and quantifying the patient liability portion. Contacting the patient the day before arrival to remind them of the appointment, set the expectation for payment, and answer any questions the patient may have.

Responsibilities

• Pre-registers Outpatients and Inpatients.
• Verifies that the insurance coverage is in effect, determines the amount of coverage and patient liability.
• Verifies that Pre-certification has been obtained whenever appropriate and works with the Physician’s office staff to obtain it whenever needed.
• Demonstrates respect and regard for the dignity of all patients, families, visitors, and fellow employees to ensure a professional, responsible, and courteous environment.
• Contacts scheduled patients the day prior to their appointment to confirm they are coming and verify that all demographic and insurance information is correct.

Requirements

• Requires critical thinking skills, decisive judgment, and the ability to work with minimal supervision.
• Must be able to work in a stressful environment and take appropriate action.

Qualifications

• High school diploma or equivalent required.
• HFMA’s Certified Patient Account Representative (CPAR) designation preferred.
• 3 to 5 years in a customer service-focused environment.