Insurance Verifier- Business Office - Kelsey Seybold - Pearland TX

UnitedHealth Group•Pearland, TX

5d•$18 - $32

About The Position

The ASC Insurance Verifier works under the general direction of the ASC Business Office Manager and verifies patients’ insurance eligibility, benefits, and requirements related to scheduled services. The role determines patient copayments and calculates coinsurance and deductibles for facility and professional services. It uses the practice management system’s eligibility tools, payer portals, telephone IVR, and direct contact to obtain information efficiently, then communicates relevant details to the clinic and/or patient before or during the visit. The position is expected to meet productivity and quality standards. Responsibilities are divided among departmental work (40%), customer service (30%), productivity and quality (20%), and other assigned duties (10%). The role supports the surgery verification process, maintains accurate account and benefit information, communicates with patients, coworkers, insurance companies, and other third parties, and helps address patient financial obligations. The position is based in Pearland, Texas. The advertised hourly pay range is $18–$32, based on full-time employment and factors including labor market, education, experience, and certifications. The employer describes a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401(k) contribution, subject to eligibility requirements.

Requirements

High school diploma or GED.
At least 1 year of experience in a fast-paced medical office or facility setting with patient registration, appointment scheduling, or medical billing experience.
At least 1 year of experience with medical insurance verification.
Knowledge of managed care.
Knowledge of health insurance types and terms.
Familiarity with CPT, ICD-9, and HCPCS coding.
Basic PC literacy and ability to navigate the Internet.
Good mathematical skills, including the ability to apply percentages.
Demonstrated good customer skills.
Fast and accurate computer and data-entry skills.
Effective communication skills.
Ability to speak, hear, write, and read clearly.

Nice To Haves

Some college.
At least 3 years of experience in a fast-paced medical office or facility setting with patient registration, appointment scheduling, or medical billing experience.
At least 3 years of experience with medical insurance verification and authorizations.
Experience using the Epic software system.
Comprehensive knowledge of managed care.
Familiarity with CPT, ICD-9, and HCPCS coding in a facility setting.
Excellent customer service skills.
Bilingual English/Spanish.

Responsibilities

Ensure the accuracy of account demographic, insurance, and billing information in the computer system.
Review surgery schedules and EPIC work queues for patient accounts requiring financial review.
Complete insurance verifications at least three days before add-on surgeries and optimally two weeks before other scheduled surgeries.
Obtain required authorizations or precertifications at least three days before add-on surgeries and optimally two weeks before other scheduled surgeries.
Use the practice management system, payer websites, or telephone to obtain insurance eligibility and benefit information.
Calculate facility and professional patient responsibility using benefits, managed care contract allowances, and CPT code order when applicable.
Enter patient demographic, insurance, and verification information into the computer system according to established procedures.
Link referrals, create claim information, and enter applicable claim and precertification authorization numbers.
Link hospital encounters in registration and record benefit information in patient CRM records.
Refer verification-process questions or problems to the department Lead or Business Office Manager.
Update address information and follow up with the physician secretary regarding coding or scheduling changes to ensure accurate UR issuance.
Reconcile verified appointments against the current surgery schedule to identify missed verifications.
Mail patient benefit letters daily when applicable.
Keep current on managed care contracts and payer requirements, and keep the department Lead or Business Manager informed of activity status.
Assist with other duties as requested by Management.
Provide polite, courteous, and friendly service to internal and external customers and coworkers.
Communicate effectively with interdepartmental teams, including the UR department, departmental secretaries, nurses, and physicians.
Initiate payment arrangements when appropriate and inform the Team Lead or Business Office Manager when a patient cannot meet financial obligations.
Resolve phone issues related to patient obligations when patients have arrived at the front desk.
Assist other office personnel with heavy phone traffic as requested.
Communicate professionally and courteously with insurance companies and other third parties.
Demonstrate Kelsey-Seybold’s mission and values.
Meet or exceed verification quality and productivity standards.