Insurance Verifier

Prime Healthcare•Chicago, IL

5d•Onsite

About The Position

The Insurance Verifier contacts health plan carriers to obtain eligibility information and ensures accurate, current information is verified and entered into patient accounts. The role helps patients understand their insurance coverage and financial responsibilities, coordinates payment for scheduled and elective services according to payer requirements before services are rendered, collects payments, discusses payment arrangements, and creates cost estimates. The Insurance Verifier advises patients in person and by phone about insurance benefits and coverage and, in some cases, assesses and validates physician orders for appropriateness. The position also responds to insurance inquiries from patients and internal and external stakeholders, researches insurance requirements and resolves errors, prepares activity and outcome reports for management, gathers information for financial assistance requests, and documents communications and follow-up in the EMR. The employee participates in education opportunities to stay current with payer changes in the healthcare industry.

Requirements

Minimum two years’ experience in a hospital admissions or billing setting preferred.
Well versed in authorization processes for all payers.
Knowledge of medical terminology and insurance policies.
Excellent organization, time management, oral communication, and written communication skills.
Ability to learn quickly, work independently, and collaborate within a team environment.
Ability to maintain good working relationships.
Attention to detail and ability to multitask.
Ability to work in a demanding environment.
Problem-solving skills.
Proficient computer skills.
High school graduate or GED equivalent.

Nice To Haves

Minimum two years’ experience in a hospital admissions or billing setting.

Responsibilities

Contact health plan carriers to obtain eligibility information and verify and enter accurate, up-to-date information into patient accounts.
Assist patients in understanding insurance coverage and financial responsibilities.
Coordinate payment for scheduled and elective services according to payer specifications before services are rendered.
Collect payments, discuss payment arrangements, and create estimates.
Advise patients in person and over the phone about insurance benefits and coverage.
In some cases, assess and validate physician orders for appropriateness.
Provide customer service to patients regarding insurance inquiries and manage insurance-related queries from internal and external stakeholders.
Prepare reports on insurance verification activities and outcomes for management review.
Problem-solve insurance errors and research insurance requirements.
Gather information required to process financial assistance requests.
Document communications and follow-up in the EMR.
Participate in education opportunities to remain current with payer changes in the healthcare industry.