Insurance Verifier

Astrana Health•Tustin, CA

About The Position

The Insurance Verifier oversees all admissions and confirms proper verification of patient’s coverage. Reviews all inpatient admissions to verify and re-verify plans, ensures plan codes are correct, and appropriately documents in systems. Key Responsibilities Reviews all inpatient and outpatient admissions, including daily Managed Care report from the previous day, to ensure insurance verifications are accurate and complete. Contacts the insurance carrier to verify eligibility for the billing department. Ensures health plans are contacted in an appropriate and timely manner when pre-certification is required. Enters insurance verification information into Optimum and All Scripts. Ensures all insurance information is current and accurate. Re-verifies all insurance information on the 2nd and 16th of each month. Appropriately notifies leadership and case management of any changes in coverage. Contacts contracted vendor to screen patient for insurance coverage. Reviews the daily Bill Hold Report for any accounts which do not have verification completed, appropriately completes verification, and enters initials to document/verify completion. Maintains confidentiality with regard to patients, families, employees, and visitors.

Requirements

One year of admitting/registration office experience
High School Diploma or GED
Basic Understanding of Medical Terminology
Excellent written and verbal communication skills in English
Strong time management skills
Ability to multitask and maintain a work pace appropriate to workload
Computer literacy and proficiency
Must demonstrate customer service skills appropriate to the job

Responsibilities

Reviews all inpatient and outpatient admissions to ensure insurance verifications are accurate and complete.
Contacts the insurance carrier to verify eligibility for the billing department.
Ensures health plans are contacted in an appropriate and timely manner when pre-certification is required.
Enters insurance verification information into Optimum and All Scripts.
Ensures all insurance information is current and accurate.
Re-verifies all insurance information on the 2nd and 16th of each month.
Appropriately notifies leadership and case management of any changes in coverage.
Contacts contracted vendor to screen patient for insurance coverage.
Reviews the daily Bill Hold Report for any accounts which do not have verification completed, appropriately completes verification, and enters initials to document/verify completion.
Maintains confidentiality with regard to patients, families, employees, and visitors.