Insurance Verification Specialist

RIVERVIEW SURGICAL CENTER LLC • South Sioux City, NE

108d

About The Position

The position is responsible for verifying insurance coverage prior to patient arrival for evaluation and determining if the surgery center is in or out of network for patients. The role includes completing insurance verification forms with correct benefit information, providing estimates to patients on financial responsibility, and generating daily reports of evaluations to verify insurance is within network. Additionally, the position involves obtaining referrals and prior authorizations from policies that require it, answering patient phone calls promptly, and addressing patient concerns. The individual will also serve as a backup for registration and scheduling, comfort patients by anticipating their anxieties, and ensure the reception area is clean and organized. Protecting patient confidentiality is crucial, as is maintaining a polite phone manner and obtaining revenue by recording and updating financial information.

Requirements

• Must have high school diploma and or equivalent.
• Working knowledge of insurance verification, benefits, prior authorization, medical necessity, and coordination of benefits.
• Attention to detail and ability to accurately input data.
• Knowledge of medical terminology, Word, Excel, Outlook, PC, telephone skills, customer service, time management, organization, attention to detail, multi-tasking, flexibility, and professionalism.
• Ability to perform each essential duty satisfactorily.
• Ability to read and interpret documents such as physician orders, safety rules, operating and technical instructions, and policy and procedures manuals.
• Ability to create routine reports and correspondence.

Responsibilities

• Verifying insurance coverage prior to patient arrival for evaluation.
• Completing insurance verification forms with correct benefit information.
• Providing estimates to patients on financial responsibility.
• Generating daily reports of evaluations to verify insurance is within network.
• Obtaining referrals and prior authorizations from policies that require it.
• Answering patient phone calls promptly and addressing patient concerns.
• Obtaining proper insurance information and providing it to patients.
• Serving as a backup for registration and scheduling.
• Comforting patients by anticipating their anxieties and answering questions.
• Keeping the reception area clean and organized.
• Protecting patient confidentiality and securing protected health information.
• Maintaining a polite, consistent phone manner using proper telephone etiquette.
• Recording and updating financial information and collecting patient charges.
• Controlling credit extended to patients with prior approval.
• Filing, collecting, and expediting third-party claims.

What This Job Offers

• Education Level: High school or GED
• Number of Employees: 11-50 employees