Insurance Specialist Full Time

United Surgical Partners International Inc (USPI)•Oklahoma City, OK

19d

About The Position

Community Hospital is hiring a full-time Insurance Specialist and offers a $500 sign-on bonus. The role financially secures patient accounts within established timeframes by completing payer notifications, obtaining authorizations, verifying coverage and benefits, reviewing and correcting pre-registration financial information, and documenting information in account notes. The specialist maintains operational knowledge of insurance payers and requirements to support maximum and timely reimbursement, while contributing to an efficient, complete, and timely patient registration process that reflects Community Hospital and Northwest Surgical Hospital’s customer-service philosophy. At Community Hospital, the specialist notifies Case Management daily of inpatient and observation admissions so insurance companies are informed of patient status. Across all facilities, the role collects and verifies patient financial and insurance information, secures notifications and authorizations, communicates payment expectations, supports collections and account documentation, answers patient billing questions, and works with department leadership to resolve potential reimbursement issues. The specialist also supports registration coverage, monitors productivity as requested, meets quality and productivity standards, protects patient confidentiality, and performs other assigned duties. The organization describes its culture through C.A.R.E.S. values: Compassion is required, Attitude is valued, Respect is demanded, Excellence is expected, and Service is commended.

Requirements

High school graduate or equivalent required.
Experience in patient registration, verification, and authorization in a medical center or comparable setting required.
Working knowledge of managed care, Medicare, workers’ compensation, indemnity, and other third-party payers required.
Working knowledge of governmental regulations and other reimbursement criteria required.
Ability to type accurately at 40 words per minute, complete forms and simple correspondence, and enter data.
Excellent verbal and written communication and interpersonal skills.
Ability to handle multiple tasks with short timelines, prioritize and organize work, and complete assignments accurately and on time.
Ability to communicate effectively, tactfully, and diplomatically with patients, families, medical staff, co-workers, employers, and insurance company representatives.
Pleasant disposition, positive attitude, and ability to maintain a cordial, professional approach during stressful periods.
Ability to use office equipment, including a computer, photocopier, telephone, fax machine, and calculator.
Ability to think and act decisively in a timely manner.
Ability to maintain operational knowledge of insurance requirements necessary to achieve optimal reimbursement.

Nice To Haves

Two years of college preferred.

Responsibilities

Notify Case Management daily of inpatient and observation admissions at Community Hospital so insurance companies receive notice of patient status.
Obtain required financial and insurance information from patients, their representatives, scheduling offices, or physician offices by fax, telephone, or personal interview.
Verify insurance coverage and benefits for all registered patients through insurer websites, eligibility programs, or telephone contact, aiming to stay at least three business days ahead of patient arrivals.
Complete payer notifications and obtain pre-authorizations and/or pre-certifications for timely and accurate reimbursement.
Determine the appropriate financial class and accurately enter information into the system.
Communicate coverage details and expected co-payments, co-insurance, and deductibles to patients or guarantors before the service date.
Establish payment arrangements according to established guidelines and attempt to collect patient payments during initial phone contact when appropriate.
Log cash collections, generate receipts, maintain a balanced cash drawer, and post payments to patient accounts as required.
Document account information that may help the business office understand billing issues, claim status questions, or follow-up needs.
Assist patients who visit the facility in person with billing questions or open accounts.
Inform the Department Director or Team Lead about potential problem accounts or additional reimbursement requirements and seek direction on resolution.
Provide high-quality customer service and communication to internal and external contacts, supporting a positive hospital encounter for patients and families.
Respond to incoming calls within the third ring.
Meet established individual and team quality and productivity standards.
Adapt positively to changes in hospital policies, procedures, operations, and insurance requirements, and reinforce team-based results.
Follow time and attendance standards and provide proper notice of absence or tardiness within departmental timeframes.
Protect patient confidentiality and adhere to HIPAA guidelines.
Demonstrate the required knowledge, skills, and abilities annually through testing or daily quality review and direct observation.
Track and monitor productivity as requested.
Keep the Department Director informed of delays in the registration process.
Stay current on scheduling, registration, insurance verification, and other patient registration processes to cover for other team members when needed.
Perform other duties as assigned.