Insurance Verifier

WILSON COUNTY MEMORIAL HOSPITAL DISTRICTFloresville, TX
Onsite

About The Position

Works directly with clinics to identify and secure payer referral requirements for maximum reimbursement.

Requirements

  • Strong, working knowledge of insurance payers to include government, commercial and managed care products
  • Ability to establish a good rapport with outside providers and third party payers
  • Resourceful, steadfast attitude to make sure that patient needs are met timely
  • Comfortable with navigating through the payer websites to secure appropriate benefits and authorization requirements
  • Excellent verbal and oral communication skills
  • Excellent customer service skills are expected with internal and external customers
  • Must be able to multitask and demonstrate excellent organizational skills
  • Understanding of insurance contracts and networks essential
  • Computer literate, knowledge of, or ability to learn multiple clinic/hospital software required.

Nice To Haves

  • Extensive coding and medical terminology preferred

Responsibilities

  • Work requests from a queue or email communication from clinic staff or other source
  • Confirm validity of any referrals already on file
  • Submit request for needed referrals to appropriate authority or PCP
  • Follow up to secure authorization prior to patient appointment to ensure reimbursement
  • Provide requested clinical information to PCP to support referral
  • Advise clinic staff of any anticipated delays for authorization
  • Secure referrals and enter them in the patient’s electronic record
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