Insurance Verifier

Opelousas General Health System • Opelousas, LA

1d • Onsite

About The Position

This is a full-time position for an Insurance Verifier responsible for obtaining verification and pre-certification for all scheduled and non-scheduled emergency and direct admits. The role requires accuracy in documenting insurance benefit and pre-certification information before billing. The representative will also answer basic insurance questions, maintain communication with physicians and staff, and understand insurance pre-certification requirements. Additionally, the role involves entering insurance information into the computer, updating departments on patient status changes, understanding Medicare, Medicaid, HMO, and PPO rules, assisting with registrations during busy periods, and helping patients arrange payments for services not covered by insurance.

Requirements

• High School Diploma required.
• 1 year of experience in Hospital admissions and/or billing experience.

Responsibilities

• Performs all functions necessary to obtain verification and pre-certification on all scheduled and non-scheduled emergency and direct admits.
• Ensures accuracy of all insurance benefit/pre-certification information prior to billing.
• Answers basic insurance questions and/or refers appropriately as necessary.
• Verifies and pre-certifies insurance according to department policy.
• Documents all activity relative to the account.
• Maintains good communication with physicians and staff to promote a good working relationship.
• Demonstrates a clear understanding of insurance pre-certification requirements.
• Enters all relevant insurance benefits and pre-certification information into computer.
• Keeps UR and Business Services department updated on any changes in status of all in-house patients.
• Demonstrates a basic understanding of Medicare, Medicaid, HMO and PPO rules, regarding inpatient vs. Observation stays and pre-certification requirements.
• Assists with registrations when needed in extremely busy conditions.
• Helps patients arrange payment for services that are not covered by their insurance companies.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED