Insurance Specialist -Temp

WVU Medicine

8d•Onsite

About The Position

Performs a variety of administrative and clerical duties to manage patient registration and patient financial obligation. This role involves obtaining demographic, billing, and insurance information from patients, entering it into registration/billing systems, and scanning necessary documents. The specialist also provides patients with information regarding insurance and hospital procedures, may handle managed care responsibilities like pre-certification, and prepares various consent forms and paperwork for patient signatures. Additionally, the role includes collecting payments, balancing receipts, performing medical necessity checks, and scheduling/rescheduling patient appointments.

Requirements

High school graduate or equivalent.
State criminal background check and Federal (if applicable), as required for regulated areas.
Ability to accurately utilize applicable computer software and equipment for access processing & demonstrates ability to follow down time procedures.
Demonstrate knowledge of procedure to report and/or document unsafe/hazardous conditions, incidents and defective equipment in compliance with hospital policy.
Requires considerable attention to detail, the ability to be organized and to be able to perform multiple tasks simultaneously.
Requires the ability to memorize a considerable amount of information, and to be able to reference information not retained from written sources or from appropriate personnel.
Requires the ability to understand medical insurance requirements for payment and basic knowledge of covered services.
Excellent written and verbal communication skills and the ability to understand written and verbal communication.
Basic knowledge of medical terminology.

Responsibilities

Obtains demographic/billing/insurance information from patient/family/legal guardian and enters into the registration/billing systems for service and claim processing and scans insurance cards & photo identification.
Provides to the patient, information concerning insurance, payment of bills and hospital procedures.
May complete managed care responsibilities in regard to obtaining pre-certification and authorizations.
Prepares WVU Medicine standard consent form, notice of privacy practice and/or other necessary paperwork related to registration and presents to patient/family/legal guardian for signatures.
Obtains electronic signature for consent to treat and patient financial obligations.
Collects deposits/co-payments/deductibles/patient liability payments when applicable, provides patient receipt and documents payment in the registration/billing systems.
Prepares armband for patient identification.
Balances daily receipts and cash drawer for patient payments as needed.
Follows up on accounts as indicated by system flags (courtesy dismissal/comments/red stickers).
May initiate various screenings and obtains all pertinent information for coverage and completes appropriate paperwork.
Performs medical necessity checks and completes Advanced Beneficiary Notice as needed.
Schedules, reschedules, or cancels patients in accordance with hospital workflows.
Checks for order completeness and validate order against scheduled service.