Insurance Verifier/Financial Counselor

Prime Healthcare•Elgin, IL

4d•Onsite

About The Position

The primary function of the insurance verification specialist is to contact health plan carriers to obtain eligibility information ensuring that the most accurate up to date information is verified and entered into patient’s account. Assist patients in understanding their insurance coverage and financial responsibilities. Coordinates payment for all scheduled/elective services required according to payer specifications prior to services rendered. Collects payments, discusses payment arrangements as appropriate, creates estimates, advises patents in person and over the phone on their insurance benefits coverages and in some cases assesses and validates physician orders for appropriateness. Provide excellent customer service to patients regarding insurance inquiries. Manage any insurance related queries from internal and external stakeholders. Prepares reports on insurance verification activities and outcomes for management review. Problem solves insurance errors and research insurances requirements. Gathers all relevant information required to process financial assistance requests. Documents all communication and follow up in the EMR. Pursues and participates in education opportunities to remain current with payer changes in the healthcare industry.

Requirements

Minimum two years’ experience in hospital admissions or billing setting preferred.
Well versed in authorization processes for all payers.
Knowledge of medical terminology and insurance policies.
Excellent organization and time management skills.
Excellent oral and written communication skills.
Ability to learn quickly, work independently and collaboratively within a team environment.
Ability to maintain good working relationships.
Demonstrates attention to detail and ability to multitask.
Ability to work in a demanding environment.
Problem solving skills.
Proficient computer skills.
High School Graduate or GED Equivalent Required (effective 4/1/14 for all new hires).

Responsibilities

Contact health plan carriers to obtain eligibility information, ensuring accurate and up-to-date information is verified and entered into the patient's account.
Assist patients in understanding their insurance coverage and financial responsibilities.
Coordinate payment for all scheduled/elective services according to payer specifications prior to services rendered.
Collect payments and discuss payment arrangements as appropriate.
Create estimates and advise patients on insurance benefits and coverages.
Assess and validate physician orders for appropriateness.
Provide excellent customer service regarding insurance inquiries.
Manage insurance-related queries from internal and external stakeholders.
Prepare reports on insurance verification activities and outcomes for management review.
Problem-solve insurance errors and research insurance requirements.
Gather all relevant information required to process financial assistance requests.
Document all communication and follow-up in the EMR.
Pursue and participate in education opportunities to remain current with payer changes in the healthcare industry.