Job Summary
This position is responsible for verification of insurance benefits, calculating patient responsibility, and patient phone interviews, as well as maintenance of associated records. Demonstrates the primary goal of efficiently providing surgical services that exceed customer expectations and improve clinical and financial operations.
Qualifications
- Ability to read, write, type, and perform calculations at a level generally acquired through completion of high school.
- Knowledge of medical terminology.
- Communication and interpersonal skills with a strong emphasis on telephone interviewing techniques.
- Ability to work with stand alone or integrated health care computerized systems preferred. Familiarity with fundamental software packages (Word, Excel) preferred.
- Good command of the English language, both verbal and written.
Working Conditions and Physical Requirements
- Lifting up to 50 pounds.
- Regularly required sitting. Walking, kneeling, stooping and bending are also required
The following description of the job responsibilities and performance expectations are intended to reflect the major responsibilities of the job, but is not intended to describe the minor duties or other responsibilities as may be assigned from time to time. Reasonable accommodations may be made to perform the essential functions
Insurance Verification
- Sets priorities and organizes work
- Verifies patient insurance benefits by contacting insurance companies and interpretation of managed care contracts. Determines precertification requirements and resolves any issues with physician offices.
- Determines patient responsibility for cash payment based on reimbursement and account reviews. Accepts payments and is responsible for the security and accurate accounting of payments received.
- Accurately uses procedure codes to ensure proper billing.
- Reviews financial records for correctness.
Personal Development and Professionalism
Serves as a resource to other members of the health care team.
- Attends in services, conferences and meetings as required
- Attends annual Safety and Competency education session
- Maintains designated certifications such as CPR as offered by the center.
- Act in accordance with the vision, mission, and business philosophy of the Center
- Maintain patient, physician, and employee privacy and confidentiality per policy.
- Follow the Center's professional conduct and dress code policy.
- Communicate effectively and courteously with visitors, physicians and their office staffs, patients and employees.
- Assists with other responsibilities of center as deemed necessary by management
Required Skills
EDUCATION, TRAINING AND EXPERIENCE REQUIREMENTS:
- 2-3 years previous experience in insurance verification, with emphasis on healthcare insurance collections of all types. Preference shown to previous experience in an ambulatory surgical setting.
- Medical terminology.
- Prefer previous experience working with Advantx. (Patient Accounting System)
- Ability to work independently.
- Excellent communication skills and interpersonal skills.
- Skilled in time management and prioritization of emergent situations.
- Good customer service skills, always demonstrates professionalism.
- Comfortable utilizing critical thinking skills.
- Typing 45-60 WPM.
- High School Diploma or equivalency.
- Proficient with Microsoft Office products.
- Experience with electronic patient information systems.
- Prefer previous experience with Electronic Health Record system, but will train.
Required Experience