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Insurance Verifier/Financial Counselor

Prime HealthcareRumford, ME
Onsite

About The Position

The Insurance Verifier/ Financial Counselor is responsible for determining patient liability based on benefits and advises patient of their liability prior to scheduled elective procedures notifies patient(s) of financial responsibility; collection arrangement are made prior to services rendered for all elective care. Verifies insurance eligibility, and benefits for emergent and urgent admissions, procedures or other services ensuring communication of patient responsibility to the patient or responsible party. Verifies and secures accurate patient demographic and insurance information, updating patient account information as needed. Assists patients in making arrangements as needed for patient responsibility by time of discharge for emergent or urgent services. Screens and refers patients for possible linkage to state, county or other government assistance programs as well as Charity or Discounts as per the facility Charity and Discount policies. The Insurance Verifier/ Financial Counselor works closely with Case Management in securing Medicaid/Medical treatment authorizations as needed. Maintains effective communication skills, including verbal, written and telephone. Proficient in mathematical skills.

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

  • Determining patient liability based on benefits and advising patient of their liability prior to scheduled elective procedures.
  • Notifying patient(s) of financial responsibility and making collection arrangements prior to services rendered for all elective care.
  • Verifying insurance eligibility and benefits for emergent and urgent admissions, procedures or other services.
  • Ensuring communication of patient responsibility to the patient or responsible party.
  • Verifying and securing accurate patient demographic and insurance information, updating patient account information as needed.
  • Assisting patients in making arrangements as needed for patient responsibility by time of discharge for emergent or urgent services.
  • Screening and referring patients for possible linkage to state, county or other government assistance programs as well as Charity or Discounts as per the facility Charity and Discount policies.
  • Working closely with Case Management in securing Medicaid/Medical treatment authorizations as needed.
  • Maintaining effective communication skills, including verbal, written and telephone.
  • Proficient in mathematical skills.

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