INSURANCE VERIFIER (Full-time) NRMC Wound Care Clinic

Natchitoches Regional Medical CenterNatchitoches, LA
Onsite

About The Position

The Insurance Verifier for NRMC Wound Care Clinic must be a self-motivated person to perform office functions of insurance verification and Authorizations. The associate verifies all insurance coverage for clinic patient visits, surgeries, and/or procedures in the clinic and at the hospital. The associate will be able to work without constant oversight and has the ability to multitask in a changing environment subsequent to the number of patients at one time. Will maintain the mission and core values set forth by Natchitoches Regional Medical Center.

Requirements

  • High school diploma or GED required.
  • One-year admission experience required.
  • Ability to read, write, speak, understand, and communicate effectively in English (other languages desirable)
  • Ability to concentrate when there are numerous interruptions.
  • Knowledge of third-party payers.
  • Knowledge of admission procedures.
  • Knowledge of automated systems and basic computer software.
  • Ability to type 50 wpm.
  • Ability to meet deadlines and work with time constraints.
  • Ability to use appropriate discretion in handling confidential material and information.
  • Good telephone techniques.
  • Ability to deal with public in a tactful manner.
  • Ability to perform detailed assignments, work accurately, follow directions and assesses priorities.

Nice To Haves

  • Vocational training in office procedures preferred.
  • One to two years of college preferred.
  • Six months medical business office experience preferred.
  • Knowledge of medical terminology preferred.
  • Previous experience with insurance billing in a hospital, similar medical facility, or physician’s office preferred.

Responsibilities

  • Verifies all insurance and workers compensation benefits for all scheduled outpatient procedures.
  • Obtains pre-certification or prior authorizations for scheduled outpatient procedures.
  • Obtains PCP referrals required by third party payer.
  • Verifies eligibility for Medicare, Medicare HMOs, Skilled Payers, and Medicaid payers.
  • Verifies Skilled patients and obtains authorizations for skilled patients from skilled facilities.
  • Verifies and calls patients regarding their deductibles, co-pays, and payment arrangements.
  • Documents all pertinent and additional information obtained from the insurance company in the computer on the patient’s account and makes any necessary corrections.
  • Verifies that information on computer screen matches the information on insurance cards exactly.
  • Coordinates/schedules ancillary testing with other hospital departments. Obtains and verifies patient insurance information, to include pre-certifications and pre-authorizations for services and enters data in appropriate databases.
  • Assists in the registration process as required.
  • Provides insurance information to physicians as requested.
  • Actively participates in staff meetings to support key functions within the Center.
  • Participates in emergency and disaster situations.
  • Performs miscellaneous duties as deemed appropriate and when assigned by supervisor.
  • Maintains patient information in Meditech and IHeal.
  • Provides hospital billing office with charts when needed for billing.
  • Keeps all accounts updated with notes and scanning in Meditech and IHeal.
  • Will perform all duties above in Meditech and Iheal as required for pre-certifications authorizations and verifications.
  • Will float to other departments as necessary.
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