Insurance Verifier

USPI•Dallas, TX

2d•Onsite

About The Position

North Central Surgical Center is currently seeking a Full-Time Insurance Verifier in our Business Office Department. This role involves retrieving and verifying patient information, confirming insurance benefits, obtaining necessary authorizations, and calculating patient financial responsibilities. The Insurance Verifier will also communicate with patients regarding payments due and assist front-end staff with eligibility and responsibility inquiries. Miscellaneous job-related duties may also be assigned.

Requirements

Ability to retrieve patient information and verify accuracy.
Proficiency in verifying patient insurance benefits via online portals or direct contact with carriers.
Skill in obtaining authorizations, pre-certifications, requirements, and referrals.
Knowledge of high-cost implant/supply or equipment rental inclusion on authorizations.
Ability to check insurance company approved procedure lists/medical policies.
Competence in calculating patient deductibles and copays based on contract interpretation.
Experience entering data into patient accounting systems and spreadsheets.
Ability to contact patients regarding payments due prior to surgery.
Skill in determining patient financial responsibility based on contract and account reviews.
Proficiency in filling out verification sheets and uploading to patient charts.
Ability to assist front-end staff with eligibility and patient responsibility inquiries.
Capability to answer department calls and assist patients with benefit inquiries and quotes.

Responsibilities

Retrieves patient information, verifying patient information is accurate (spelling of name, D.O.B., gender, etc.).
Verifies patient insurance benefits by utilizing online websites or by contacting the carriers directly.
Obtain authorizations from insurance companies/physician offices, pre-certification, requirements and referrals as needed.
Ensure high cost implant/supply or equipment rental is included on authorization.
Check insurance company approved procedure lists/medical policies.
Calculates patient deductibles and/or copays based on contract interpretation of Managed Care Contracts and enter into the patient accounting system and spreadsheets provided.
Contact patients regarding moneys due prior to date of surgery.
Determine patient responsibility for payment based on contract and account reviews.
Determine patient responsibility for cash payment based on reimbursement and account reviews.
Fill out verifications sheet and upload to patient charts.
Assist front end staff in understanding verification of eligibility and/or patient responsibility.
Answer incoming department call and assist patients with their benefit inquires & quotes.
Performs miscellaneous job-related duties as assigned.