Insurance Verification Specialist

Prime Healthcare•Blue Springs, MO

23h•Onsite

About The Position

We are seeking an Insurance Verification Specialist, also referred to as a Hospital Insurance Verifier and Financial Counselor, for our Admitting Department. This role involves verifying patient insurance eligibility and benefits, determining financial responsibility, and communicating this information to patients before procedures. The specialist will also assist patients with payment arrangements, refer eligible individuals to assistance programs or discounts, and collaborate with Case Management to secure necessary authorizations, maintaining clear communication throughout the process.

Requirements

Knowledge of standard insurance companies and verification requirements.
Well versed in authorization processes for all payers.
Ability to multi-task, prioritize needs to meet required timelines.
Analytical and problem-solving skills.
Customer Services experience required.
High School Graduate or GED Equivalent Required (effective 4/1/14 for all new hires)

Responsibilities

Verify patients’ insurance coverage and benefits thoroughly prior to hospital admission or scheduled procedures to ensure accurate billing and eligibility
Assess and determine patient financial responsibility based on insurance details and communicate this information clearly to both patients and hospital staff
Coordinate the pre-authorization and insurance approval process to ensure all necessary approvals are secured before services are provided
Maintain and update accurate patient insurance and demographic information within the hospital’s electronic health record system to support smooth admissions and billing
Guide and assist patients in accessing available financial assistance programs, answering billing questions, and resolving insurance-related concerns to ease their hospital experience