Insurance Verifier/Financial Counselor

Prime Healthcare•Harlingen, TX

4d•Onsite

About The Position

The Insurance Verifier/Financial Counselor determines patient liability based on benefits and advises patients of their liability prior to scheduled elective procedures. They notify patients of financial responsibility and ensure collection arrangements are made before services are rendered for all elective care. This role also verifies insurance eligibility and benefits for emergent and urgent admissions, procedures, or other services, communicating patient responsibility to the patient or responsible party. The position involves verifying and securing accurate patient demographic and insurance information, updating patient accounts as needed, and assisting patients in making arrangements for their financial responsibility by the time of discharge for emergent or urgent services. Additionally, the Insurance Verifier/Financial Counselor screens and refers patients for potential linkage to state, county, or other government assistance programs, as well as Charity or Discounts according to facility policies. They work closely with Case Management to secure Medicaid/Medical treatment authorizations and maintain effective communication skills, including verbal, written, and telephone. Proficient mathematical skills are also required.

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

Determine patient liability based on benefits and advise patient of their liability prior to scheduled elective procedures.
Notify patient(s) of financial responsibility; collection arrangements are made prior to services rendered for all elective care.
Verify insurance eligibility and benefits for emergent and urgent admissions, procedures or other services ensuring communication of patient responsibility to the patient or responsible party.
Verify and secure accurate patient demographic and insurance information, updating patient account information as needed.
Assist patients in making arrangements as needed for patient responsibility by time of discharge for emergent or urgent services.
Screen and refer patients for possible linkage to state, county or other government assistance programs as well as Charity or Discounts as per the facility Charity and Discount policies.
Work closely with Case Management in securing Medicaid/Medical treatment authorizations as needed.
Maintain effective communication skills, including verbal, written and telephone.
Proficient in mathematical skills.