Insurance Verification Associate

Genesis Healthcare System•Moline, IL

4d•Onsite

About The Position

Responsible for verifying benefits and/or obtaining pre-certification/pre-authorization for all exams scheduled at the facility. Assists with coordinating care for all patients with prescheduled diagnostic appointments within the imaging center including pre-screening and preparation instructions prior to and after patient arrival. Handles correspondence regarding patient insurance, authorization, demographics, appointments, and financial information as applicable. Handles all correspondence, maintains files, acts as a patient liaison, receptionist, screens telephone calls within department and compiles departmental monthly reports.

Requirements

High school graduate or equivalent.
Knowledge of insurance verification, with two years experience verifying and obtaining medical pre-certification.
Solid written and verbal communication skills.
Strong computer experience, including MS Word and Excel, and experience using other office equipment. Will be required to learn department-specific programs.
Demonstrated ability to prioritize and handle multiple tasks simultaneously.
Ability to work with minimal supervision and effectively solve problems.
Working knowledge of medical terminology.

Responsibilities

Working knowledge of authorization criteria specific to both insurance payor and exam type.
Working knowledge of retro authorization and appeals process and attempting to obtain when needed.
Maintain an understanding of authorization standardization workflow.
Ensures that patients have a physician order before tests are performed or at the time of scheduling.
Understanding of the patient registration process including patient demographic, insurance benefits, and financial responsibility information.
Collect patient co-payments, deductibles, bad debt, and outstanding balances when applicable.
Manages multiple phone lines efficiently and with excellent customer service skills and telephone etiquette.
Verifies all medical benefits for scheduled exams and communicates medical insurance coverage to the patient and/or legal guardian.
Provide good faith estimates to self-pay patients timely to remain in compliance with the No Surprise Act.
Inform all true self-pay patients of presumptive eligibility opportunities and financial counseling options available.
Collaborate with the physician's office staff as appropriate to obtain the necessary documentation, including pre-authorizations for all diagnostic exams.
Pre-register all patients in an accurate and efficient manner.
Demonstrates understanding of medical diagnosis with correct spelling.
Demonstrates complete understanding and ability to apply patient access policies and procedures.
Demonstrates knowledge to scan appropriate documents and search for documents in EPIC.
Demonstrates knowledge of insurance and authorization web portals.
Demonstrates ability to analyze and evaluate any presented problems by utilizing critical thinking.
Knowledge of electronic prior authorization process specific to Rhyme.
Consistently coordinates work to achieve maximum productivity and efficiency during the assigned shift.
Demonstrates a willingness to stay late, and work weekends or other shifts to accommodate department needs.