Insurance Verification Associate Jobs in Virginia

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Monday-Friday 10:30am-7:00pm
Job Summary:
This position is accountable to obtain and verify all patient insurance and pre-authorization information, perform scheduling functions, and collect self-pay, co-pay, and patient deductibles. The incumbent in this position is accountable to perform a variety of clerical, reception, and other support functions that will ensure timely and effective day-to-day operations and communications throughout the Medical Imaging of Frederickburg (MIF) locations. This includes, but is not limited to, answering telephones, greeting patients, entering outpatient imaging orders, maintaining records, and monitoring flow.

Essential Functions & Responsibilities:

• Greets all customers in a courteous and professional manner. Addresses customers' needs efficiently, effectively, and confidentially. Provides excellent customer service and supports the facility annual customer service goals.
• Answers telephones courteously, professionally, and promptly. Screens and transfers telephone calls or takes messages as appropriate.
• Assists in the handling of various patient financial matters.
• Schedules tests as ordered by a physician or their through appropriate scheduling software.
• Maintains documentation necessary for compliance with state, federal and other regulatory agency requirements. Collects insurance cards and valid ID card.
• Obtains authorization information from insurances via their website as applicable.
• Monitors scheduling work-lists to ensure timely scheduling and insurance verification.
• Provides patients and/or physicians' offices instructions for proper pre-procedure preparation.
• Communicates with insurance companies to determine appropriate benefits, required co-pays, documents pre-authorizations, and prorates bills with management approval, to accurately secure proper reimbursement from insurance companies and patients.
• Maintains an organized and efficient work area. Monitors patient schedules, workflow, and activities of all imaging sub-sections to assure a smooth and coordinated traffic flow. Ensures patients, family members, and Associates are kept informed of activities and delays. Provides ongoing follow-up regarding delays for affected patients.
• Monitors appropriate reports. Maintains knowledge of CPT and ICD-10 codes, ensuring orders are entered accurately and efficiently.
• Reconciles daily charges. Ensures correct CPT, ICD-10, referring physician, and correct charging information.
• Performs closing procedures to include tallying daily charges and procedures vs. Epic daily patient log report, reconciles credit card transactions; submits total charges and balances, and collected co-pays and outpatient fees.
• Prepare and maintain CD and film requests and fax-and-confirm requests by obtaining appropriate HIPAA guidelines and departmental processes.
• Maintain adequate inventory of supplies and materials and keep patient records in an organized fashion.
• Distributes final reports of all procedures to the ordering doctors as appropriate.
• Serves as a liaison to the patient/guarantor, insurance company, and physician office to ensure all necessary approvals for services rendered and received are documented appropriately.
• Enters all necessary pre-authorization documentation into Radiology Management Systems (RMS) via the revised schedule information screen to ensure correct transfer of information for billing, and efficient follow-up with patients/guarantors and third-party payers.
• Reviews pre-authorization denial reports provided by the billing company to ensure accuracy of the pre-authorization process.
• Provides assistance in other areas of the MIF departments as needed.
• Performs other duties as assigned.

Qualifications:

• High school diploma or equivalent.
• Basic computer skills. Strong verbal and written communications skills required.
• Two (2) years related experience in a call center, patient registration, patient accounts, or patient billing preferred.
• Experience in third party insurance and insurance terminology, CPT, and ICD-9 codes preferred

As an EOE/AA employer, the organization will not discriminate in its employment practices due to an applicant's race, color, religion, sex, sexual orientation, gender identity, national origin, and veteran or disability status.

Required

Physical Requirements: Constant (67-100% of workday) sitting and use of arms and hands; occasional (0-33% of workday) standing, walking, bending, squatting; ability to lift, push, and pull up to 10 lbs.; auditory and visual skills.

Mental Requirements: Possesses critical thinking and analytical skills. Ability to multi-task. Ability to communicate effectively and collaborate with a multi-disciplinary team.

Environmental Requirements and Exposure Hazards: Potential risk of exposure to chemicals.

"It is the policy of Mary Washington Healthcare to provide reasonable accommodations to qualified individuals with a disability who are applicants for employment or Associates."