Insurance Verification Specialist

National Jewish Health•Denver, CO

8d•$21 - $27

About The Position

The Insurance Verification Specialist is responsible for verifying insurance coverage online, over the phone and via fax. This position is responsible for verifying if referrals and authorizations are required for scheduled services and providing this information either to the patient or other departments within the facility.

Requirements

High school diploma or equivalent required.
2 years experience in a healthcare setting working with insurance verifications/authorizations required.

Nice To Haves

Associate’s degree preferred.
Outpatient hospital experience preferred.

Responsibilities

Identifies and enters insurance demographics.
Verifies specialty outpatient and inpatient insurance, both primary and secondary coverage (when applicable by service type), within set timeframes determined by Administrative Services Management.
Verification includes obtaining and documenting covered and non-covered benefits, plan types, co-payments, co-insurance, out of pocket, and deductible amounts and determining contract and benefit eligibility.
Verifies authorization standards for testing performed at National Jewish Health.
Submits authorization requests for which clinical support can be faxed or for which clinical documentation is not required.
Assists with notifying the clinical insurance authorization specialist when their support will be needed to complete authorizations requiring clinical support.
Maintains communications with patients to keep them apprised of their insurance referral requirements and eligibility status.
Acts as a problem solver with patients regarding their insurance plan.
Notifies the Patient Financial Counseling Office of any significant gaps in coverage and/or high co-pays or deductibles prior to services being rendered for non-local patients.
Maintains a thorough understanding of referral requirements, all major and local insurance plans and all ancillary procedures conducted by National Jewish
Meets productivity goals as established by Administrative Services and reports daily productivity data to supervisor.
Maintains knowledge of medical terminology, all current procedural and diagnosis codes.
Utilizes provided resources to obtain new codes as payers change and coding requirements are updated.
Be available to work as scheduled and report to work on time.
Be willing to accept supervision and work well with others.
Be well groomed, appropriately for your role and wear ID Badge visibly.
Be in compliance with all departmental and institutional policies, the Employee Handbook, Code of Conduct and completes NetLearning by due date annually.
Promotes a workplace culture based on mutual respect and merit, where all individuals are treated fairly and provided with equal opportunity to contribute to the mission and goals of the institution.
Adheres to safe working practices and at all times follows all institutional and departmental safety policies and procedures.
Wears appropriate PPE as outlined by the infection control policies and procedures.
Demonstrates compliance with all state, federal and all other regulatory agency requirements.

Benefits

Comprehensive Medical Coverage: Multiple Cigna health plans for Colorado, regional office and remote employees. Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA) available to pair with some plans.
Paid Time Off: Generous PTO accruals to use for vacation and sick days, and six paid holidays, all compliant with Colorado state sick leave regulations.
Dental & Vision Plans: Coverage effective the first of the month after hire.
Retirement Savings: 403(b) plan with employer contributions after two years.
Wellness Incentives: Earn up to $200 annually for preventive health activities.
Tuition Reimbursement: Up to $5,250 annually for full-time and part-time employees.
Child Care Assistance: Childcare Flex Spending Account (FSA) with annual employer contribution.
Loan Forgiveness: Public Service Loan Forgiveness (PSLF) eligible employer.
Disability & Life Insurance: Employer-paid plans and optional buy-up choices.
Voluntary Benefits: Full suite of coverage options such as Accident, Hospital Indemnity and Legal Plan
Exclusive Discounts: Savings on local services, insurance, and RTD bus passes.