Insurance Verification Specialist - 91009

Hillsboro Medical Center • Hillsboro, OR

241d • $23 - $32

About The Position

The Insurance Verification Specialist is responsible for verification of all insurance to determine actual benefits of in-patient and outpatient procedural and admitted accounts requiring an extensive knowledge on medical insurance. This role includes notifying all insurance companies of outpatient and inpatient admissions for authorization, auditing IP/OP procedural accounts, and obtaining prior authorizations for facility services that require such. The specialist provides excellent customer service to patients and staff alike.

Requirements

• Minimum one (1) year of hospital and insurance verification experience.
• Computer experience.
• Medical billing and insurance terminology required.
• Medical terminology required.
• Requires self-discipline and sense of responsibility, as job requires strict attention to detail.
• Excellent customer service skills.
• Must be effective in verbal and written communication.
• Ability to read and understand physician's orders.
• Utilizes electronic equipment and communication devices.
• Effectively uses online databases throughout the insurance verification process.
• Assumes responsibility for maintaining competency in all areas where training was completed.
• Demonstrates confidentiality regarding patient and co-worker information according to PHI level of access.
• Prioritizes workload.
• Looks for ways to improve customer service.
• Formulates and uses effective working relationships with all healthcare team members, patients and significant others.
• Fosters positive work environment through teamwork and assistance.
• Demonstrates the ability to be self-disciplined, motivated and a self-starter.

Nice To Haves

• Associate degree with college accounting courses or equivalent accounting experience.
• Insurance contracting knowledge preferred.
• Bilingual skills a plus.

Responsibilities

• Obtains needed insurance, health and financial information on patients coming into the hospital.
• Updates patient accounts as needed.
• Communicates to patient the patient's financial responsibility as needed.
• Obtains and verifies insurance within department standard and ensures proper insurance authorization is obtained.
• Responds to voicemail within 24 hrs.
• Maintains equipment and reports equipment failures promptly to facilitate repairs.
• Refers accounts that do not have insurance to the Financial Counselor.
• Addresses Case Management concerns and complaints.
• Attends department meetings and provides insurance updates to the team.
• Reviews active medical records for presence of diagnosis and orders.
• Formulates and updates policies and procedures for insurance verification.

Benefits

• Equal employment opportunities for all qualified individuals.

What This Job Offers

• Career Level: Entry Level
• Industry: Ambulatory Health Care Services
• Education Level: No Education Listed