Insurance Verification Specialist

USPI•Roswell, GA

4h•Onsite

About The Position

Roswell Surgery Center is seeking a strong business partner in the role of an insurance verification specialist. The Insurance Verification Clerk is responsible for validating and entering patient information and insurance coverage into the appropriate computer system. Duties may also include communicating with physician offices, insurance carriers, and patient follow-ups. The role involves verifying Insurance Benefits and Determining Co-pay based on Insurance Contract. USPI, the parent company, partners with physicians and healthcare systems to provide first-class ambulatory solutions throughout the United States, committed to providing surgical services in the most efficient and clinically excellent manner. USPI is also committed to an inclusive culture that is respectful of differences and nurtures and supports the contributions of each individual, embracing and leveraging diversity to meet the needs of its diverse patient and physician population.

Requirements

High school diploma or equivalent.
One to three months of related experience and/or training.
Or Equivalent combination of education and experience.
Communication skills: ability to effectively present information to patients, physicians, and other employees of surgery center.
Basic math skills.
Employed at a doctor’s office or ASC for minimum of 12 months
Working Knowledge of Managed Care contracts and how they work
Ability to verbalize the knowledge of Managed Care Contracts
Working knowledge for manually calculating insurance allowed amounts and patient responsibility
Working knowledge and comprehension of EOB’s (Explanation of Benefits)

Responsibilities

Review Patient information.
Begin chart and pre-admission process.
Verify insurance benefits by reviewing our contract and patient’s quoted benefits.
Determine co-pay.
Post all insurance and billing comments, to include requests by BOM.
Enter all information into patient accounting system….time and date
Contact patients regarding money due prior to the date of surgery.
Contact patients of their financial responsibility in the timeliest manner that coincides with providing excellent patient experience.
Knowledgeable of the Managed Care contract and knowledgeable of the updates
As Assigned by Business Office Manager.
Participate in USPI EDGE program.
Crossed trained to efficiently cover and relieve front desk for lunches and staffing purposes.
During downtime assist in Collection Calls, assist in research for the Collection Specialist.
Enter all PHI information into system before the end of each Business day.