Insurance Verification Jobs in Canton, GA (NOW HIRING)

Children's is one of the nation's leading children's hospitals. No matter the role, every member of our team is an essential part of our mission to make kids better today and healthier tomorrow. We're committed to putting you first, and that commitment is at the heart of our company culture: People first. Children always. Find your next career opportunity and make a difference doing what you love at Children's.

Job Description

Communicates with patients, families, physicians, quality review, clinical staff, and insurance companies to obtain information and insurance verification to ensure quality patient care and payment of hospital accounts. Collaborates with Appeals department to overturn claims denials. Provides other registration, clerical, and billing support as required, including scheduling, chart creation, charge entry, scanning, and point-of-service collections.

Experience

• 1 year of experience in healthcare or related clerical, accounting, or customer service experience. Bachelor's degree or equivalent education may be considered in lieu of experience.

Preferred Qualifications

• College degree
• 1 year of experience in registration
• Certified Patient Account Representative (CPAR) or Certified Healthcare Access Associate (CHAA)
• Experience using patient registration systems, insurance verification systems, and/or Medicaid portals

Education

• High school diploma or equivalent

Certification Summary

• No professional certifications required

Knowledge, Skills, and Abilities

• Understanding of and familiarity with medical terminology
• Basic knowledge of Microsoft Windows and Word
• Strong verbal/written communication skills
• Demonstrated arithmetic and word mathematical problem-solving skills
• Excellent customer service skills
• Proven ability to multitask and must be willing to work a flexible schedule, including nights, weekends, and holidays
• Ability to travel as needed to support multiple locations or different departments
• Ability to uphold highest level of customer service while covering any location

Job Responsibilities

• Communicates with patients, families, physicians, clinical staff, and insurance companies to obtain information and insurance verification to ensure quality patient care and payment of hospital accounts.
• Interviews patients and families to obtain complete and accurate demographic and financial information and ensures all necessary questionnaires and forms are completed according to pre-determined requirements by government or regulatory agencies.
• Enters data into system for registration, billing, patient tracking, charge capture, and reconciliation in a fast, efficient way to minimize patient wait times.
• Verifies insurance coverage and/or validates authorizations if applicable.
• Explains regulatory financial requirements to patient or responsible party and collects/posts deposits or deductible amounts as required (for outside clinics, could include ensuring that referring physicians have obtained prior insurance authorization as needed and rescheduling appointments if necessary).
• Assists Patient Accounting by capturing accurate and compliant data elements to produce clean claims, preventing denials and delayed payments. Serves as liaison between patient and department staff by informing patients and families of procedures and delays, answering questions, offering assistance, relaying messages, and other services that patients and families may require. Escalates immediate needs to appropriate leaders and/or clinical team members.
• Ensures wait time communication occurs by updating schedulers and patient information tools as appropriate.
• Initiates and executes daily medical record maintenance while maintaining patient confidentiality, including creation of patient charts, filing encounter-specific paperwork, and maintaining correspondence via mailing/faxing with patient's primary care provider and/or specialists as necessary.
• Provides release of medical information as required.
• May initiate and perform administrative duties to ensure efficient daily business operations, including participating in the office/department opening and closing procedures, assisting with maintaining, ordering, and restocking front office supplies, and receiving and distributing mail.
• Schedules patient appointments when needed, including referral from faxes, phones, or other instructions and contacts physician offices to resolve discrepancies.
• Coordinates all aspects of scheduling including procedures, provider visits, and use of resources.
• Attends and participates in department meetings according to department standards and may serve on committees representing the department, which could include multi-disciplinary quality and service improvement teams.
• Assists Supervisor and/or Manager by being available to teammates, acting as a resource to help complete complicated/complex tasks, on the job training to team, and seeking out opportunities to become actively involved in staff workflow and development.
• Prescreens doctor's orders (scripts) received for new patients to ensure completeness/appropriateness of scheduled appointment (clinic setting).
• May prepare case review materials for court preparation for forensic interviewers and providers (clinic setting/Center for Safe and Healthy Children).
• Coordinates subpoena process between court system, Child Protection Center, and legal department and facilitates billing process for expert testimony in court cases (clinic setting/Center for Safe and Healthy Children).

Children's Healthcare of Atlanta is an equal opportunity employer committed to providing equal employment opportunities to all qualified applicants and employees without regard to race, color, sex, religion, national origin, citizenship, age, veteran status, disability or any other characteristic covered by applicable law.

Primary Location Address: 2270 Duluth Hwy