Insurance Verification Clerk

Midland Health•Midland, TX

About The Position

Insurance Verification Clerk’s primary responsibilities are: 1) to gather all pertinent patient information on scheduled patients; 2) to accurately pre-admit patients; 3) to pre certify all applicable admissions/pre-admissions; 4) to obtain signatures on all appropriate admissions forms if appropriate; 5) to ensure that patient benefits and eligibility are verified and the details of such are entered into the patient accounting system for all patients touched; 6) an estimate of charges will be provided to all scheduled patients and collection of all co pay’s/deductible’s that are owed to the hospital to meet departmental requirements; 7) identify and refer patients to the financial assistance department at hospital; and 8) to provide a full range of insurance verification functions on an as needed basis as requested by Management. Additionally, all job duties will be completed in a manner that is consistent with the highest quality of guest relations which results in a positive experience for the patient and/or their family member(s).The position also requires accountability for admitting/registering and/or providing verbal directions to patients and/or family members in any or all the following age groups: neonatal, pediatric, adolescent, and/or geriatric demonstrating the appropriate skills to understand and react effectively to the needs of these patients and/or family members.

Requirements

Must be a high school graduate or equivalent
Basic math skills are required
Excellent customer service and communication skills
Must be able to use Microsoft Excel, Office and Outlook
Ability to accurately complete data entry tasks for new and established MMH patients including all required paperwork (i.e. consent forms, ABN, MSP forms, etc.)
Ability to interpret payer contracts, understanding different types of reimbursement methodology and accurately figure and communicate patient estimated out of pocket expenses to patients and guarantors.
Ability to accurately complete insurance verification, authorization and pre-certification requirements of each different payer source and apply those benefits to determine a patient’s estimated out-of-pocket expense.
Ability to provide accurate financial counseling information to patient or guarantor and makes the appropriate referrals to the eligibility office when necessary following hospital policies and procedures in patient balance collections.
Ability to document all patient/guarantor interactions into the patient accounting systems

Nice To Haves

1 year office experience preferred

Responsibilities

Gather all pertinent patient information on scheduled patients
Accurately pre-admit patients
Pre certify all applicable admissions/pre-admissions
Obtain signatures on all appropriate admissions forms if appropriate
Ensure that patient benefits and eligibility are verified and the details of such are entered into the patient accounting system for all patients touched
Provide an estimate of charges to all scheduled patients and collection of all co pay’s/deductible’s that are owed to the hospital to meet departmental requirements
Identify and refer patients to the financial assistance department at hospital
Provide a full range of insurance verification functions on an as needed basis as requested by Management
Complete data entry tasks for new and established MMH patients including all required paperwork (i.e. consent forms, ABN, MSP forms, etc.)
Interpret payer contracts, understanding different types of reimbursement methodology and accurately figure and communicate patient estimated out of pocket expenses to patients and guarantors
Accurately complete insurance verification, authorization and pre-certification requirements of each different payer source and apply those benefits to determine a patient’s estimated out-of-pocket expense
Provide accurate financial counseling information to patient or guarantor and makes the appropriate referrals to the eligibility office when necessary following hospital policies and procedures in patient balance collections
Document all patient/guarantor interactions into the patient accounting systems