Insurance Verifier - Munson Medical Oncology MUST RESIDE IN MICHIGAN

Munson Healthcare•Cadillac, MI

4h•Remote

About The Position

This is a remote position that requires the employee to reside in Michigan. The role involves exercising a high degree of control over confidential medical information, including inputting and updating insurance details, verifying insurance eligibility, and identifying primary and secondary insurance. The position also requires obtaining claim numbers, verifying claims for Workmen's Comp and Auto Insurance, and identifying the need for pre-authorization. The Insurance Verifier will obtain and document pre-authorization for scheduled patients and communicate pre-authorization guidelines to Utilization Management for emergent patients. Responsibilities include following up on verification issues, staying current on billing requirements from various third-party carriers, and obtaining pre- and retro-certification information for inpatient activity. The role also involves referring patients to Financial Counselors when appropriate and performing other related duties.

Requirements

2 Year / Associate Degree or Equivalent experience
1.5 years of related experience in healthcare
Advanced keyboard, mouse, computer and Microsoft Office skills.
Must have knowledge and ability to learn, access and utilize 10+ of the computer programs listed below within 90 days of hire.
Must possess exceptional oral and written communication skills.
Ability to demonstrate effective communication with patients, Dr’s offices and technicians within hospital departments, and create accurate documentation with information gathered.
Must be warm, friendly, and sensitive to the feelings and concerns of others.
Ability to demonstrate effective communication with Insurance companies to obtain, verify, and create accurate documentation with information gathered.
Ability to perform online insurance verification through the Internet.
Must demonstrate ability to adapt to change and keep up with continued advanced education requirements.
Munson Healthcare requires all employees be vaccinated or have lab confirmed immunity for Measles, Mumps, Rubella and Varicella.
MHC also requires all employees to receive a flu vaccine during the flu season in the year that they are hired and annually thereafter, or receive an approved medical or religious exemption.

Nice To Haves

Medical experience is preferred
Well versed in medical terminology is highly preferred

Responsibilities

Inputs and updates all insurance information in appropriate screens.
Verifies eligibility of all insurances available online or by phone.
Identifies primary and secondary insurance. Inputs insurance information in correct COB order.
Obtains claim numbers and verifies that claims are established for Workmen’s Comp and Auto Insurance.
Identifies the need for pre-authorization information, makes decisions relating to insurance eligibility utilizing several online systems available at MMC.
Scheduled patients: Obtains and documents pre-authorization as appropriate for procedure.
Emergent patients: obtains pre-authorization guidelines and communicates information to Utilization Management.
Follow up on all verification issues in a timely manner and communicate information to proper departments regarding information obtained.
Responsible to keep current on billing requirements from third parties such as, Blue Cross/Blue Shield, Medicare, Medicaid, and all other health insurance carriers.
Performs insurance verification, obtains pre- and retro- certification information for all inpatient activity.
Communicates appropriate information to the Utilization Management team as required.
Refers patients to Financial Counselors to obtain financial assistance and /or payment arrangements when appropriate.