Insurance Verification/Authorization

Description

The Insurance Verification & Authorization position is responsible for verifying all commercial insurance coverage and determines patient's responsibility. They will do this electronically and/or by phone as appropriate. Enters all insurance information clearly and accurately into medical records system. Possesses good problem solving skills and is versatile and willing to coordinate with and participate in, when necessary, all other aspects of the business.

Job Responsibilities

• Responsible for reviewing patients’ case and insurance coverage information to personalize the call contents to the patient.
• Demonstrated ability to deal effectively with emotionally charged situations.
• Choose the right HARP internal software insurance code following information provided on patients’ insurance.
• Study patients’ scanned requisition record and input all information relating to insurance coverage.
• Take and verify all patients’ demographic information when registering them for the service or program. Identify important patient and demographic information that are missing and inform client about them to avoid claim processing issues with the insurer.
• Establish contact with the ordering physician’s office or customer service department to resolve issues concerning missing vital information from patients scanned requisition record.
• Ensure timely processing of benefit information and seek assistance from management when necessary.
• Work cordially in a team and participate in meetings, sharing ideas and information.
• Ensure all inpatient files are available for daily verification and authorizations of insurance benefits by printing census.
• Self- Motivation and ability to work effectively in an independent environment.
• Provide quality customer service by being available for scheduled shifts. Includes arriving promptly to meet the demands of the daily call levels.
• Excellent communication and organizational skills.

Other Functions:

Performs other related duties as assigned for the purpose of ensuring the efficient and effective functioning of the work unit.

Requirements

Education and Experience

Must have a High School Diploma or equivalent.

Previous experience with insurance verification and authorization required.

Ability to type and operate a PC.

Knowledge of medical terminology

Physical Demands

While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle, or feel; reach with hands and arms; and talk or hear. The employee is occasionally required to stand and walk. The employee must frequently lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, distance vision, depth perception, and ability to adjust focus. This job operates in a professional environment. This role routinely uses standard office equipment such as computers, phones, photocopiers and fax machines.