Insurance Verifier

St. Luke’s University Health Network•Allentown, PA

About The Position

St. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care. The Insurance Verifier is responsible for verifying insurance eligibility and benefits for all Network inpatient/observation admissions and transfers within one business day. The Verifier corrects identified errors and notifies appropriate parties so authorizations can be obtained and accurate billing can occur. The Verifier refers all identified uninsured/underinsured accounts to the Network Financial Counselors.

Requirements

High School Diploma or equivalent.
Must be able to speak, read and write English.
Ability to navigate websites and web-based applications is required.
Use of computer keyboard and typing skills required.

Nice To Haves

Experience within health care related to registration, verification or third-party billing in a hospital, similar medical facility, or physician’s office is preferred.
Personal computer experience with knowledge of Excel, Word, and Outlook preferred.
Previous clerical experience desired.

Responsibilities

Verifies insurance coverage and obtains benefits for all Network inpatient and observation admissions.
Ensures accurate information so that other teams can obtain authorizations and perform billing functions.
Documents detailed accurate benefit and deductible information in EPIC.
Responds promptly to internal/external customer insurance inquiries and contacts internal/external entities when additional information is needed.
Reverifies coverage for admitted patients every 15 days until discharged.
Calculates and tracks estimated remaining Medicare days.
Communicates findings to Financial Counselors and others as appropriate.
Identifies uninsured/underinsured patients or accounts with incomplete insurance information and promptly communicates issues to Financial Counselors for follow up.
Submits notification of admission for Veterans through the Veterans Community Care Network for all Network Veteran ED visits and non-elective ED/direct observation/inpatient admissions within 72 hours.
Tracks and follows up on VA responses until authorization/determination is received and patient is discharged.
Meets or exceeds productivity and quality performance standards.
Other related duties as assigned.