Insurance Verifier Jobs

TOPS Surgical Specialty Hospital

Main Function -

Contacts all insurance companies to verify description of patient(s) medical plan benefits. Estimates patient financial responsibilities and insurance reimbursement. Interacts with physicians, personnel, and patients regarding financial and authorization issues. Responsible for gathering and inputting patient demographic and financial information into the computer. The Insurance Verifier is also responsible for correcting information in the computer to ensure a clean claim. Demonstrates the primary goal of efficiently providing surgical services that exceed customer expectations and improve clinical and financial operations.

Duties and Responsibilities -

Duties and

Responsibilities

• Contacts all insurance carriers per patient, to insurance proper coordination and reimbursement of benefits.
• Maintain continuity of work operations by documenting and communicating actions, irregularities, and continuing needs and communicate problems according to established procedures.
• Financial Practices
• Performs according to established compliance policies and procedures
• Contributes to the progress and development of the organization's adopted performance-improvement program
• Reports observed or suspected safety violations, hazards, and policy/procedure noncompliance to the safety officer or other designated person
• Mathematical skills required to calculate percentages, interest and practical application of accounts payable functions.
• Interacts with others in a positive, respectful, and considerate manner
• Performs according to established performance-improvement policies and procedures
• Greets and directs patients and visitors for the facility.
• Assists with other responsibilities of center as deemed necessary by management.
• Serves as a resource to other members of the health care team.
• Gathers patient information by collecting demographic information from a variety of sources: interacting with the registration areas and physicians’ offices; retrieving information from systems.
• Follows the facility’s standards for ethical business conduct
• Displays the ability to comprehend and interpret verbal orders and direction
• Conducts self as a positive role model and team member
• Protects the financial integrity of the facility by verifying implant cost and specific insurance clinical policy bulletins for ever changing insurance processes.
• Perform registration procedures as written in Policy and Procedure Manual.
• Duties
• Seeks new learning experiences by accepting challenging opportunities and responsibilities
• Communicates effectively and professionally with patients, visitors, physicians, and coworkers
• Safety/Risk-Management Program
• Capability to work with rigid deadlines while maintaining a high degree of accuracy.
• Reports wasteful practices
• Shares knowledge gained in continuing education with staff
• Uses facility resources appropriately and avoids wasteful practices
• Assists in answering incoming calls for a high volume phone queue.
• Adheres to safety policies and procedures in performing job duties and responsibilities
• Ability to troubleshoot equipment issues and notify all pertinent team members in a timely manner.
• Communication
• Communicate effectively and courteously with visitors, physicians and their office staffs, patients and employees.
• Demonstrates knowledge of the various computer systems used at facility.
• Participates in development of Policies and Procedures within the department.
• Recognizes patients’ rights and responsibilities and supports them in performance of job duties
• Performs in accordance with the facility’s policies and procedures
• Analyzes work area and makes recommendations for potential cost-effective improvements
• Welcomes suggestions and recommendations
• Breaks down managed care contract reimbursements and estimates patient’s financial responsibilities.
• Displays skill in oral and written communication techniques
• Supports the facility’s ideology, mission, goals, and objectives
• Compliance Program
• Participates in facility committees, meetings, in-services, and activities
• Act in accordance with the vision, mission, and business philosophy of the Center
• Able to calculate patient out of pocket to set up approved payment arrangements if necessary.
• Perform high quality work.
• Participates in continuing education and other learning experiences
• Has complete knowledge of Insurance Verification duties and responsibilities.
• Enters information in computer system in an accurate manner.
• Participates in Performance Improvement Plan.
• Professional Competence
• Contributes to the progress and development of the organization’s adopted compliance program
• Participates in data collection activities to support the performance-improvement program
• Maintain patient, physician, and employee privacy and confidentiality per policy.
• Performance-Improvement Program
• Follow the Center's professional conduct and dress code policy.
• Philosophy
• Adheres to Policies and Procedures as defined by Infection Control.

#USP-ST

#USP-123

Required Skills:

• Time management
• Professionalism
• Accuracy
• Little supervision needed to accomplish tasks
• Accountability
• Organization
• Quality Focus
• Thoroughness
• Attention to detail
• Productivity

Required Experience:

Cooperative work attitude toward co-employees, management, patients, visitors, and physicians.

Ability to promote favorable facility image with physicians, patients, and general public.

Ability to make decisions and solve problems.

High school diploma or GED certification.

Great attitude.

CPR Certification.

Proficient typing/ keyboarding skills.

One year of experience in a hospital or customer service setting.