Insurance Verifier, Ambulatory Patient Access Harlingen

Dhr Health Institute For Research And Development • Harlingen, TX

402d

About The Position

The Insurance Verifier in Ambulatory Patient Access at DHR Health is responsible for determining insurance eligibility and financial status for patients. This role involves reviewing insurance information, verifying benefits, and communicating with third-party payers to ensure proper coverage and authorization for services. The position requires excellent customer service skills and the ability to work in a fast-paced environment, particularly with geriatric patients.

Requirements

• High School Diploma or GED required.
• Minimum of 2 years of insurance verification/referral experience preferred.
• Comprehensive understanding of insurance benefits, referral requirements, and medical terminology.
• Excellent customer service skills required.
• Ability to work with geriatric patients in a high-volume, fast-paced practice.
• Proficient in Microsoft Office and internet usage.
• Excellent written and verbal communication skills required.
• Knowledge of ICD and CPT codes, HCPCS coding preferred.

Nice To Haves

• Bilingual in English and Spanish preferred.
• Experience in a physician office setting preferred.

Responsibilities

• Determine insurance eligibility and financial status by reviewing insurance information via phone or online verification.
• Call third-party payers to obtain insurance benefits, including effective dates of coverage and patient financial responsibility.
• Monitor and verify benefits on accounts requiring referrals and authorizations daily.
• Assist billing staff with researching accounts with discrepancies in payments, rejections, and denials.
• Handle calls and questions from patients, physicians, insurance carriers, and ancillary providers regarding referrals and authorizations.
• Confirm billing addresses, in and out of network benefits, and maximum coverage for services provided.
• Review and confirm patient's financial information, including policy numbers and effective dates of coverage.
• Utilize phone and online verification systems for eligibility, benefits, and authorization submission.
• Ensure referral/pre-authorization/pre-certification requirements are met in a timely manner.
• Document all patient benefit information clearly and concisely in the patient accounting system.

Benefits

• Health insurance coverage
• Paid holidays
• Flexible scheduling
• Professional development opportunities

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Hospitals
• Education Level: High school or GED