Insurance Verifier - SPI Family Wellness Clinic

Harlingen Rio Grande Medical Group•Harlingen, TX

1d•Onsite

About The Position

We are seeking an Insurance Verifier, sometimes referred to as a Hospital Insurance Verifier and Financial Counselor in our Wellness Clinic. The Insurance Verifier verifies patient insurance eligibility and benefits, determines financial responsibility, and communicates this to patients before procedures. The clinic Insurance Verifier assist patients with payment arrangements and refer eligible individuals to assistance programs or discounts. Additionally, Insurance Verifiers collaborate with Case Management to secure necessary authorizations and maintain clear communication throughout the process.

Requirements

Knowledge of standard insurance companies and verification requirements.
Well versed in authorization processes for all payers
Ability to multi-task, prioritize needs to meet required timelines
Analytical and problem-solving skills
Customer Services experience required
High School Graduate or GED Equivalent Required (effective 4/1/14 for all new hires)

Responsibilities

Verify patients’ insurance coverage and benefits thoroughly prior to hospital admission or scheduled procedures to ensure accurate billing and eligibility
Assess and determine patient financial responsibility based on insurance details and communicate this information clearly to both patients and hospital staff
Coordinate the pre-authorization and insurance approval process to ensure all necessary approvals are secured before services are provided
Maintain and update accurate patient insurance and demographic information within the hospital’s electronic health record system to support smooth admissions and billing
Guide and assist patients in accessing available financial assistance programs, answering billing questions, and resolving insurance-related concerns to ease their hospital experience