Insurance Verification Manager Jobs in Maryland (NOW HIRING)

The Patient Access Coordinator is an established, non-clinical healthcare professional dedicated to facilitating seamless patient experiences and optimizing operational efficiency while ensuring compliance with regulatory standards. Leveraging strong organizational skills and advanced knowledge of patient registration protocols, the PAC delivers exceptional customer service, supporting Luminis Health's goals of financial reimbursement and overall excellence in patient care.

1.           Patient Interaction and Identification:

         Greet patients and visitors courteously, always maintaining empathy and professionalism.

         Accurately identify patients in the Master Patient Index to reduce erroneous duplicate medical records, maintaining a 98% accuracy rate in medical record creation.

         Update demographics per legal identification.

         Verify the information on armbands before placing them on patients.

         Explain all required documents verbally, obtain signatures appropriately, and document any inability to obtain signatures correctly, including immediate scanning into EMR, per process.

         Process all 'unable to sign' consents per process, including following legal algorithms to research and communicate with patient contacts to obtain appropriate surrogate; escalate to next steps (Care Management) when unable to find surrogate.

2.           Patient Registration and Insurance Verification

         Conduct face-to-face interviews to accurately obtain and process patient demographic and financial information, maintaining a minimum accuracy rate of 97% for error-free registrations.

         Process and act on Real-Time Eligibility (RTE) messages, including adding, terminating, and correcting coverages.

         Identify all true self-pay patients accurately and forward to Medicaid eligibility and application staff, ensuring only true self-pay patients are screened.

         Scan all required documents into patient records and place HAR notes on accounts when necessary.

         Identify and resolve insurance verification issues, informing patients of available options, including financial assistance.

3.           Regulatory Compliance:

         Ensure all patients receive necessary regulatory information and enter appropriate documentation in the EMR (e.g., HIPAA, Patient Rights Brochure, IMM, NOOS, ABN, etc.)

         Explain hospital policies, procedures, and financial responsibilities to patients and their families, providing excellent customer service.

4.           Financial Communication:

         Communicate financial responsibilities to patients and collect funds accordingly.

         Make referrals to Charity Care and Medical Assistance when needed.

5.           Workflow Management:

         Independently prioritize PAC workflow, including work queue management, patient registrations, insurance verification, and other assigned tasks to meet personal performance and productivity metrics within department deadlines.

         Identify and correct errors in accounts using appropriate tools.            

         Answer and direct incoming and external calls promptly.

6.           Appointment Scheduling:

         Schedule appointments, surgeries, and other medical procedures according to patient and provider preferences.

         Verify insurance coverage and obtain pre-authorizations as needed.

7.           Training and Mentoring:

         Assist with training new staff following all processes and procedures in the training program.

8.           Shift Coordination:

          Act in a Shift Coordinator role as needed and assigned under the direction of the Supervisor.

9.           Meeting and Training Participation:

         Attend all departmental staff meetings and stay current with departmental updates.

         Read and respond to emails during each shift.

         Attend all required in-person training/in-services and complete all educational assignments within the required timeframe.

10.       Adherence to Policies:

         Adhere to hospital policies and procedures, including timely arrival, minimal absences, appropriate attire, readiness for work, and minimal personal electronic usage.

         Adhere to the RISE values. Contribute to a positive work environment that promotes teamwork, collaboration, professionalism, and continuous improvement.

11.       Coordination with Other Departments:

         Contact physician offices for patient care orders and seek faxed orders when necessary.

         Communicate with Nursing and EVS regarding bed placements and discharges for inpatients.

         Communicate with Discharge Planning when demographic or insurance changes are made for patient registrations.

         Conduct bed assignment duties accurately and quickly.

         Interview patients face-to-face or by phone to obtain registration information.

12.       Additional Responsibilities:

         Perform other duties as assigned by the Director, Manager, or Supervisor.

Requirements:

         High School Diploma

         Minimum 8 months in patient access role

         Excellent communication and interpersonal skills

         Strong attention to detail and accuracy

         Proficiency with computer systems and electronic health records.

         Ability to work independently and collaboratively in a fast-paced environment

         Compassionate attitude and a commitment to providing exceptional patient care.

         Certified Patient Access Specialist (CPAS):

External Candidates: Must obtain within 4 months of employment

Internal Candidate: CPAS obtained as part of initial 8 months of employment

There is a reasonable expectation that employees in this position will be exposed to blood-borne pathogens.

Physical Demands - Light Work - Exerting up to 20 pounds of force occasionally and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects. 

The physical demands and work environment that have been described are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions in accordance with the Americans with Disabilities Act.

The above job description is an overview of the functions and requirements for this position.  This document is not intended to be an exhaustive list encompassing every duty and requirement of this position; your supervisor may assign other duties as deemed necessary.