Insurance Verification Representative

HCA Healthcare • San Antonio, TX

8d

About The Position

The Pre-Registration/Insurance Verifier verifies patients’ health insurance, government program, and/or workers’ compensation eligibility and benefits before examinations. The role also confirms insurance claims billing addresses and determines whether a scheduled procedure requires pre-certification or prior authorization to be performed and reimbursed.

The representative contacts referring physician offices for additional information when needed to obtain authorization, and notifies the referring physician office, patient, and/or imaging center when an exam is not authorized or will not be covered. The position supports the mission and goals of South Texas Radiology Imaging Centers, provides excellent customer service, follows safety policies and the STRIC Code of Conduct, and completes other assigned duties.

Requirements

• High school graduate or GED.
• Excellent phone etiquette and communication skills.
• Proficiency in operating modern telephone, computer, and office equipment.
• Working knowledge of medical terminology.
• Working knowledge of health insurance, government programs, and workers’ compensation.

Responsibilities

• Verify policy and group numbers, guarantor and dependent information, eligibility, benefits, and the insurer’s claims mailing address.
• Document scheduling changes appropriately in the patient’s history notes.
• Determine whether an examination requires pre-certification or pre-authorization to be performed and reimbursed.
• Contact referring physician offices to obtain additional information needed to request exam authorization.
• Notify the referring physician office, patient, and/or imaging center when an exam is not authorized or will not be covered.
• Support the organization’s mission and goals and demonstrate excellent customer service.
• Follow system and facility safety policies, use appropriate safety procedures and equipment, and report unsafe conditions.
• Adhere to the STRIC Code of Conduct and report activity that may violate applicable laws, regulations, or the Code.
• Complete other duties as assigned.

Benefits

• Medical, prescription drug, dental, vision, behavioral health, and telemedicine benefits.
• Wellbeing support, including free counseling and referral services.
• Paid time off, paid family leave, long- and short-term disability coverage, and leaves of absence.
• 401(k) plan with a 100% match on 3% to 9% of pay, based on years of service.
• Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support, and financial wellbeing counseling.
• Tuition assistance, student loan assistance, certification support, dependent scholarships, and a partnership with Galen College of Nursing.
• Fertility and family-building benefits and adoption assistance.
• Life insurance and supplemental health protection plans.
• Auto and home insurance, legal counseling, identity theft protection, and consumer discounts.

What This Job Offers

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