Insurance Verifier - Hybrid

Education:

• High School diploma, Associates degree preferred or 2 year’s formal education or college experience
• Medical Terminology required or successful completion of medical terminology course in the probationary period.  Failure to complete medical terminology will result in termination of employment.

Work Experience:

• Two (2) year’s work experience in customer service, healthcare or business related field.

• Advanced keyboard, mouse, computer and Microsoft Windows skills are required. Must have basic knowledge of Insurance Verification processes.

• Under the general supervision of the System Manager of Pre Services, Patient Access Services and the Patient Financial Services System Coordinator(s). Organizationally reports to the System Director of Patient Access Services.  May receive input/instructions from other PAS Managers and Patient Financial Services Directors.

 Job Duties

Insurance Responsibilities:

• Educates and informs patients of insurance requirements as needed.
• Inputs and updates all insurance information in appropriate screens.
• Verifies eligibility of all insurances available on line.
• Follow up on all verifications not retrievable in a timely manner.
• Verifies primary and secondary insurance.  Sequences Blue Cross/Blue Shield, Medicare, Medicaid, Workman’s Compensation, Commercial and Auto Insurance as appropriate.
• Verifies that claims are open and billable for Workmen’s Compensation and Auto Insurance.
• Verifies prior authorization requirements and reaches out to ordering offices to obtain prior authorizations if needed

Collection Responsibilities:

• Refers patients to Financial Counselor for financial assistance screening and/or refers patients to Patient Accounting for payment arrangements when appropriate.
• Performs patient financial estimates on accounts using deductibles, co-pay, out of pockets, coinsurance and patient balances.

Remote Work:

• If approved: Must pass 6 - month competency test while also meeting quality and productivity standards. Once approved, must maintain quality and productivity standards

Reports:

• May assist with working various reports, including but not limited to:  Huron work lists, PRT Missing Expected Patient Type, Verification Follow-up, Denials, Radiology Protocols, and Address Error.

Scheduling:

• Uses current scheduling application to view various appointments.