INSURANCE VERIFICATION SPEC, FCH - ENTERPRISE REGISTRATION
About The Position
The Insurance Verification Specialist is a member of the Pre-Authorization Department who is responsible for verifying eligibility, obtaining insurance benefits, and ensuring pre-certification, authorization, and referral requirements are met prior to delivery of inpatient, outpatient, and ancillary services. This individual determines which patient services have third party payer authorization requirements and collaborates with the appropriate clinical partners, case managers, financial counselors, payers, and others to make sure the necessary authorization is obtained. The Insurance Verification Specialist provides detailed and timely communication in order to facilitate compliance with payer contractual requirements and is responsible for documenting the appropriate information in the patient's record. Other duties as assigned.
Requirements
- Minimum of one year experience in a hospital admitting/registration/billing/managed care department
- Demonstrated knowledge of health insurance plans including: Medicare, Medicaid, HMO's, and PPOs
- High School diploma or equivalent
- Knowledge of online insurance eligibility systems
- Excellent typing and computer skills
- Familiarity with Medical Terminology
- Demonstrated ability to efficiently organize work and maintain a high level of accuracy and productivity
Responsibilities
- Verifying eligibility
- Obtaining insurance benefits
- Ensuring pre-certification, authorization, and referral requirements are met prior to delivery of inpatient, outpatient, and ancillary services
- Determining which patient services have third party payer authorization requirements
- Collaborating with appropriate clinical partners, case managers, financial counselors, payers, and others to make sure the necessary authorization is obtained
- Providing detailed and timely communication to facilitate compliance with payer contractual requirements
- Documenting the appropriate information in the patient's record
Benefits
- Paid time off
- Growth opportunity- Career Pathways & Career Tuition Assistance, CEU opportunities
- Academic Partnership with the Medical College of Wisconsin
- Referral bonuses
- Retirement plan - 403b
- Medical, Dental, Vision, Life Insurance, Short & Long Term Disability, Free Workplace Clinics
- Employee Assistance Programs, Adoption Assistance, Healthy Contributions, Care@Work, Moving Assistance, Discounts on gym memberships, travel and other work life benefits available
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
