1 Associate Insurance Verifier (32 hours) Job in Brookhaven, GA
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Associate Insurance Verifier (32 hours)
$38k-46k (estimate)
Full Time | Hospital
2 Months Ago
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Children's Healthcare of Atlanta is Hiring an Associate Insurance Verifier (32 hours) Near Brookhaven, GA
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Work ShiftDay
Work Day(s)Monday-Friday
Shift Start Time8:00 AM
Shift End Time4:30 PM
Worker Sub-TypeRegular
Children’s is one of the nation’s leading children’s hospitals. No matter the role, every member of our team is an essential part of our mission to make kids better today and healthier tomorrow. We’re committed to putting you first, and that commitment is at the heart of our company culture: People first. Children always. Find your next career opportunity and make a difference doing what you love at Children’s.
Job DescriptionAuthorizes and pre-certifies services by coordinating and performing activities required for verification and authorization of insurance benefits. Proactively identifies resources available for families if health plan does not include coverage for services. Coordinates counseling services with Financial Counseling and ensures the standards of Surprise Billing is communicated. Collaborates with Patient Financial Services (PFS) and Managed Care department regarding denied claims. May initiate and perform revenue cycle activities required for pre-registration. Works collaboratively with team members to provide quality service that ensures delivery of safe patient care and services.
Experience
Job FamilyPatient Financial Services
Work ShiftDay
Work Day(s)Monday-Friday
Shift Start Time8:00 AM
Shift End Time4:30 PM
Worker Sub-TypeRegular
Children’s is one of the nation’s leading children’s hospitals. No matter the role, every member of our team is an essential part of our mission to make kids better today and healthier tomorrow. We’re committed to putting you first, and that commitment is at the heart of our company culture: People first. Children always. Find your next career opportunity and make a difference doing what you love at Children’s.
Job DescriptionAuthorizes and pre-certifies services by coordinating and performing activities required for verification and authorization of insurance benefits. Proactively identifies resources available for families if health plan does not include coverage for services. Coordinates counseling services with Financial Counseling and ensures the standards of Surprise Billing is communicated. Collaborates with Patient Financial Services (PFS) and Managed Care department regarding denied claims. May initiate and perform revenue cycle activities required for pre-registration. Works collaboratively with team members to provide quality service that ensures delivery of safe patient care and services.
Experience
- One year of experience in a healthcare patient access role (registration, scheduling)
- Bachelor's degree
- Experience in a pediatric hospital
- High school diploma or equivalent
- No professional certifications required
- Working knowledge of basic medical terminology
- Demonstrated ability to multitask and problem-solve
- Ability to work independently in a changing environment and handle stressful situations
- Must be able to speak and write in a clear and concise manner to convey messages
- Proficient in Microsoft Word/Excel/Outlook
- Knowledge of Availity, MMIS and insurance payer website.
- May require travel within Metro Atlanta area as needed
- Interviews patients and/or family members to secure insurance coverage, eligibility, and qualification for various financial programs.
- Coordinates and performs verification of insurance benefits by contacting insurance provider and determining eligibility of coverage and communicates status of verification/authorization process with appropriate team members in a timely and efficient manner.
- Provides clinical information as needed, emphasizing medical justification for procedure/service to insurance companies for completion of pre- certification process.
- Confirms referring physician and/or servicing physician has obtained notification/confirmation of prior authorization as needed from insurance company for all scheduled healthcare procedures within assigned department/area.
- Contacts referring physicians and or/patients to discuss rescheduling of procedures due to incomplete/partial authorizations.
- Acts as liaison between clinical staff, patients, referring physician’s office, and insurance by informing patients and families of any possible changes, updates, responses or follow-up. Discussion points may include the following: authorization delays, authorization denials, pending status, answering questions regarding status changes, offering assistance, providing follow up steps for financial support and relaying/documenting messages pertaining to authorization of procedure/service.
- Monitors patients on schedule, ensuring that eligibility and authorization information has been entered into data entry systems.
- Pre-screens doctor’s orders (scripts) received for new patients to ensure completeness/appropriateness of scheduled appointment.
- Collaborates with Patient Financial Services (PFS) department to provide all related information regarding denied claims.
- Monitors insurance authorization issues to identify trends and participates in process improvement initiatives.
- Responds to all inquiries related to authorization/pre-certification issues.
- Develops and maintains knowledge in medical terminology, billing and insurance guidelines to ensure Children’s remains compliant with all regulatory expectations.
Job FamilyPatient Financial Services
Job Summary
JOB TYPE
Full Time
INDUSTRY
Hospital
SALARY
$38k-46k (estimate)
POST DATE
07/30/2024
EXPIRATION DATE
08/12/2024
WEBSITE
choa.org
HEADQUARTERS
ATLANTA, GA
SIZE
7,500 - 15,000
FOUNDED
1836
TYPE
NGO/NPO/NFP/Organization/Association
CEO
DONNA HYLAND
REVENUE
$10M - $50M
INDUSTRY
Hospital
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About Children's Healthcare of Atlanta
Children's Healthcare of Atlanta operates healthcare centers that provide pediatric, cardiac, cancer and emergency care services for children.
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