Verifications Clerk Jobs (NOW HIRING)

Insurance Verification Clerk Job description

Title

Insurance Verification Clerk

Reports to:

Business Office Manager

Employee Name:

Main function

Under the direction of the Business Office Manager, the Insurance Verification Clerk performs a variety of clerical tasks, as they relate to insurance recovery and the processing of patient claims for the efficient business operation of the Surgery Center. Accountable for the accuracy of information obtained for the processing of

insurance claims for procedures done within this facility.

Duties, Responsibilities, Competencies

1.     Provides regular communication and feedback to supervisor.

2.     Speaks to and approaches others in a friendly and compassionate way; Is open to other employee suggestions

3.     Demonstrates the ability to effectively communicate with others, including physician offices, insurance companies, patients and others about insurance benefits and costs associated to procedures.

4.     Demonstrate proactive approach to problem identification and solutions.

5.     Works well with others.

6.     Demonstrate appropriate time management skills, prioritization and task completion.

7.     Exhibits proficient knowledge of health plan benefits including co-pays, deductibles and co-insurance.

8.     Ability to handle multiple assignments or pieces of work at one time. The capability of working within a stressful environment under consistent deadlines, pressures and interruptions.

9.     Demonstrates the ability to cope with and manage change.

10.  Demonstrates an exceptional grasp of required skills including: detail- oriented, commitment to accuracy, able to anticipate needs before they become critical.

11.  Self-motivated to keep self-current and relevant in skills and competency.

12.  Taking prompt and decisive action to produce service levels beyond what is minimally required in the job; Acting without prompting; regularly volunteer’s individual energy to a situation.

13.  Achieves performance excellence through skills of organization; able to create successful work flow processes; reliable in all areas of work.

14.  Seeks opportunities to accept ideas and help from co-workers to accomplish work goals; Willingness to share credit; Appreciates differences in personalities; actively seeks out opinions from others and honors them in decision making.

15.  Assumes all other duties and responsibilities: demonstrates willingness to identify and/or assume activities relative to the developmental needs of the reception department and center

Key Attributes

1.     RISE – The extent to which an employee demonstrates participation in the RISE Program

·       Respect Caring - Demonstrating an awareness for compassion toward all stakeholders

·       Integrity - Being true to what we say we believe in, doing what we say we will do and adhering to our commitments

·       Stewardship - Responsibility to properly utilize and develop our people. Property and assets while fostering a safe and secure environment

·       Efficiency - Appropriate identification, selection and management of all resources to ensure excellent clinical and financial outcomes

2.     Quality – The extent to which an employee’s work is accurate, thorough and neat.

3.     Productivity – The extent to which an employee produces a significant volume of work efficiently in a specified period of time.

4.     Job Knowledge – The extent to which an employee possesses the practical/technical knowledge required on the job as evidenced by the annual competency assessment

5.     Reliability – The extent to which an employee can be relied upon regarding task completion and follow-up.

6.     Attendance – The extent to which an employee is punctual, observes prescribed work break/meal periods and has an acceptable overall attendance record.

7.     Independence – The extent to which an employee performs work with little or no supervision.

8.     Creativity – The extent to which an employee proposes ideas, finds new and better ways of doing things.

9.     Initiative – The extent to which an employee seeks out new assignments and assumes additional duties when necessary.

10.  Adherence to Policy – The extent to which an employee follows safety and conduct rules, other regulations and adheres to company policies. (Compliance, Risk, Safety, Infection Control, Sentinel Events, Abuse, etc.)

11.  Interpersonal Relationships – The extent to which an employee is willing and demonstrates the ability to cooperate, work and communicate with coworkers, supervisors, subordinates and/or outside contacts.

12.  Judgment – The extent to which an employee demonstrates proper judgment and decision-making skills when necessary.

Education / Licensure / Certification Requirements

Required:

1.     High school diploma or general equivalency degree (EGD)

2.     Two years minimum experience medical insurance office

3.     Knowledge of heath care operations

4.     Proficient computer skills Preferred:

1.     ASC experience

2.     Microsoft Office Specialist certifications

Physical / Mental requirements

1.     Language Skills: Ability to read, analyze and interpret general business information, or governmental regulations. Ability to write reports and

business correspondence. Ability to effectively present information and

respond to questions from groups of managers, clients, patients, physicians and the general public.

2.     Mathematical Skills: Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference, and volume. Ability to apply concepts of basic algebra and geometry. Ability to apply concepts of accounting. Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations.

3.     Computer Skills: Job requires specialized computer skills. Must be adept at using MS word, spreadsheets, PowerPoint, communicate by e-mail and use scheduling software. (Add computerized EMR if applicable)

4.     Reasoning Ability: Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations.

5.     Special Requirements: Must be able to work variable hours and be flexible to meet the needs of the center’s daily surgery schedule.

6.     Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

a.     The employee must regularly lift and /or move up to 25 pounds. The employee is required to lift, and occasionally carry equipment.

b.     Specific vision abilities required by this job include close vision, peripheral vision, depth perception and ability to adjust focus. While performing the duties of this job, the employee is regularly required to stand; walk; use hands to finger, handle, or feel; reach with hands and arms and talk or hear. The employee is frequently required to stoop, kneel or crouch. The employee is frequently required to attend to patients and escort them to and from patient care areas, often being leaned on for support. Upper body strength, for lifting or helping patients, is also a must.

Working conditions (environmental)

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is occasionally exposed to work near moving mechanical parts; fumes or airborne particles; toxic or caustic chemicals; risk of electrical shock and vibration.

Medical facilities need to be as clean as possible, and excellent hygiene is required to keep patients clean and safe from sickness and infection.

Has Category 2 risk: tasks do not involve exposure to blood, body fluids, or tissues; but employment may require performing unplanned Category I tasks.