INSURANCE VER REP

UHS • Denison, TX

8d

About The Position

Texoma Medical Center is a 414-bed acute care facility serving North Texas and Southern Oklahoma. The Insurance Verification Representative performs insurance verification duties for all TMC facilities, including confirming insurance plans, contacting insurers to obtain benefits, and securing pre-certification within 24 hours of admission, except for Friday and weekend admissions. The representative provides case managers with online verification forms identifying pending clinical information and approved pre-certification days, and communicates effectively with the case management department.

The role also performs patient registration by interviewing patients or responsible parties to obtain identification and demographic information. It involves explaining TMC financial policies and collecting patient portions. The representative is expected to comply with the organization’s policies, Code of Conduct, required training, and reporting procedures.

Requirements

• High school diploma or equivalent.
• Two years of medical or healthcare business office experience.
• Basic PC experience, 10-key calculator, keyboarding, and use of office machines such as copier and fax.
• Knowledge of third-party payers, including Medicare, Medicaid, and commercial insurance.
• Strong people skills, telephone technique, personal presentation, organizational skills, and oral and written communication skills.
• Ability to work independently and remain self-motivated and flexible.
• Analytical, arithmetic, negotiation, and problem-solving skills.
• Excellent customer service skills.
• Computer skills.
• Commitment to and adherence to the STHS Compliance Program and Code of Conduct.

Responsibilities

• Verify insurance plans for all TMC facilities.
• Contact insurance companies to obtain benefit information and pre-certification within 24 hours of admission, except for Friday and weekend admissions.
• Ensure case managers receive an online verification form indicating pending clinical information and approved pre-certification days.
• Communicate effectively with the case management department.
• Register patients by interviewing patients or responsible parties to obtain identification and demographic information.
• Communicate TMC financial policies to patients and collect patient portions.
• Comply with applicable policies and procedures, the Code of Conduct, and required compliance training, and immediately report suspected compliance issues to the Compliance Officer.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED