Insurance Verification Rep - Full-Time

UHS•Wildomar, CA

11d•Onsite

About The Position

Southwest Healthcare is seeking a Full-Time Insurance Verifier will be responsible for duties related to the verification of insurance eligibility, benefits, and authorizations for multiple facilities across the region. This position will be onsite at our Medical Office Building next to the Inland Valley Hospital. Duties include but not limited to: Ensures that the systems are updated according to departmental standards. Provides notification (via fax) to case management of any insurance changes and/or requests for clinical information. Communicates effectively with internal departments, physician offices, health plans, medical groups, patients, and teammates. Calculates patient liability for hospital admissions and/or pre-scheduled procedures and forward patient estimates to the facilities Financial Counselor for collection. Provides support to PAS, PAC, and Centralized Scheduling Leadership teams.

Requirements

High School Graduate or equivalent required.
One (1) to Two (2) years’ years of experience in patient registration and/or insurance and authorization verifications in a healthcare setting required.
Proficient in Microsoft Word, Excel and Powerpoint
Ability to complete Insurance verification functions for Inpatient/Observation admissions, and pre-scheduled procedures.
Requires knowledge of general office equipment, computers, 10-key, and associated software packages.
Medical Terminology Required.
Current CA Driver’s License required.
Demonstrates knowledge and ensures compliance with the Nurse Practice Act, The Joint Commission and Title 22 standards and guidelines.
Demonstrates compliance with hospital policies and procedures at all times.
Demonstrates strong leadership, organization, communication and interpersonal skills.
Demonstrates ability to relate to clinical personnel and medical staff, as well as ability to interact well with the public.
Must have knowledge of PC and applications.
Demonstrates strong interpersonal skills, ability to interact diplomatically and to maintain a professional demeanor with physicians, the public and Healthcare staff
General knowledge of office procedures and ability to utilize resources in an organized manner.
Knowledge of insurance benefits, covered services, billing, and collection procedures for all government insurance programs and commercial programs for acute facilities.
Ability to initiate, obtain and/or update verification and authorization requirements as appropriate for patient services for each patient account.
Ability to log and maintain daily productivity goals to meet key performance indicators.
Ability to discuss personal and financial matters with patients and/or their representatives.
Ability to explain upfront cash collection policy to patients regarding the benefits quoted at the time of insurance verification.

Nice To Haves

CHAA Certified preferred.

Responsibilities

Ensures that the systems are updated according to departmental standards.
Provides notification (via fax) to case management of any insurance changes and/or requests for clinical information.
Communicates effectively with internal departments, physician offices, health plans, medical groups, patients, and teammates.
Calculates patient liability for hospital admissions and/or pre-scheduled procedures and forward patient estimates to the facilities Financial Counselor for collection.
Provides support to PAS, PAC, and Centralized Scheduling Leadership teams.