Insurance Verifier-Houston Based Remote Position

Description

LOCATION: This is a Houston-based remote position.

POSITION SUMMARY
The Insurance Verifier obtains necessary patient information from physicians' offices. The Insurance Verifier also determines how much money to collect from the patient up front and what reimbursement is expected from the insurance company.

ESSENTIAL DUTIES & RESPONSIBILITIES

Verify insurance eligibility and benefits for specific CPT and diagnosis codes. Determine is physician and facility is credentialed with plan either by telephone or the provider website.

Performs insurance pre-certification, verification, and documents information accordingly and takes payment.
Verifies and obtains all patient eligibility, authorizations, benefits, claim information with insurance companies, and 3rd party payers within the industry standard of 3-5 business days prior to date of service.
Determines and documents accordingly patient portions due, amounts to be billed, contractual discounts to be taken, or any other authorized discounts that may apply. Communicates this information with appropriate personnel for preparation of the pre-admission process. Also communicates with appropriate personnel any problems arising with the verification of benefits.
Identifies all patient accounts accurately based on what PPO, HMO, or other Managed Care Organizations the patients insurance plan might fall under.
Contacts patients and provides updates on benefit verification information, requests additional information, insurance cards, and explains to the patient his or her financial responsibility such as co-pays, co-insurance, co-deductibles, at time of service.
Accurately completes data entry necessary including authorizations and benefits as well as patient communication in the appropriate software.
Makes financial arrangements after consulting with Revenue Cycle Manager and/or Physician when patient is unable to pay amounts due in full the date of service.

Document all information in PM System, EMR system, and ASC PM.
Notifies Revenue Cycle Manager of any insurance carrier information changes.
Attends required meetings and participates in committees, as requested.
Other duties as assigned based on business operational needs.

We Proudly Offer:

• Continuing Education including JCAHPO & ABOC
• Holidays & Paid Time Off
• Bereavement Leave
• Superior Benefits Package:
  • Medical
  • Dental
  • 401(K)
  • Free Life Insurance & LTD
  • Eye Care Benefits & Optical Discounts

 Equal Opportunity Employer M/F/H/V

Qualifications

COMPETENCIES
EDUCATION High School Diploma or GED equivalent.

CERTIFICATIONS & LICENSES Not applicable
EXPERIENCE Minimum of 2 years of experience in a medical office setting. Insurance verification and calculation of benefits experience preferred. Experience with WayStar, Availity, and other insurance plans. Bilingual preferred but not required. Strong understanding of benefits investigating, deductibles, co-insurance, out of pocket expense & benefit exclusions.