What are the responsibilities and job description for the Insurance Verification Specialist - Full Time - Days position at Jupiter Medical Center?
Ranked #1 for Safety, Quality and Patient Satisfaction, Jupiter Medical Center is the leading destination for world-class health care in Palm Beach County and the greater Treasure Coast.
Outstanding physicians, state-of-the-art facilities, innovative techniques and a commitment to serving the community enables Jupiter Medical Center to meet a broad range of patient needs. Jupiter Medical Center is the only hospital in Palm Beach, Martin, St. Lucie and Indian River counties to receive a 4-star quality and safety rating from the Centers for Medicare & Medicaid Services (CMS).
Education
- High school graduate or equivalent
Qualifications
- Enthusiastic, friendly, patient focused customer service skills.
- Exemplary communication skills, written and verbal – must be comfortable speaking to patients via phone and successfully communicate pertinent information.
- Professional, effective communication skills required to contact insurance companies to obtain patient benefits.
- Must be a team player with ability to collaborate interdepartmentally and with clinical staff.
- Capacity to multi-task with computer programs while providing patients the highest level of care and attention.
- Works well in a team environment to accomplish common tasks to solve problems and enhance the smooth and efficient flow of the department.
Experience
- Minimum of 1 year experience with hospital insurance plans including Medicare, Medicaid, HMO's and PPO's.
- Excellent typing and computer skills.
- Familiarity with area managed care plans and contractual terms.
- Ability to self-direct and exercise independent judgment in situations requiring follow-up and discussions with clinical staff and/or other areas of Patient Access to ensure completion of required pre-arrival information to ensure enhanced customer service.
- Minimum of 1 year of specialized training in a health care setting with demonstrated knowledge of insurance verification and woking knowledge of authorization and pre-certification process preferred.
- Familiarty with medical terminology.
Position Summary
The Insurance Verification Specialist will be responsible for delivering a dynamic customer experience to all customers and demonstrate a strong commitment to service excellence.
The Insurance Verification Specialist initiates contact with insurance companies for verification of benefits.
- Utilizes electronic scheduling/pre-registration/financial systems, payer’s websites, and recorded calls to validate patient’s health coverage and benefits.
- Review and verify all insurance plans and confirm patient’s eligibility and benefits.
- Communicate with insurance carriers for insurance verification, obtaining patient benefits and/or follow up.
- Verify whether the plan coverage is Primary or Secondary; HMO, PPO or Commercial Carrier Insurance
- Verify plan coverage including deductibles and co-pays and the status of payment requirements.
- Verify the out-of-network requirements/benefits for each patient.
- Verify insurance for emergency and walk-in patients as requested.
- Maintain proper insurance verification documentation in the patient’s medical record.
- Input or update any demographic, insurance information, referrals, patient management, documentation into electronic file.
- Contacts and communicates all applicable insurance deductible, co-pay, arrival and procedure information and instructions to the patient prior to arrival.
- Identify patient financial responsibilities and collect applicable payment.
- Maintains the confidentialtiy of patient’s records and any related work.
- Performs other duties as assigned.
Team Member Competencies
Establishing Relationships
Builds effective networks, working relationships, and alliances in order to collaborate effectively within department and organization. Can relate to all kinds of people regardless of background; find topics and common interests that can be used to build rapport with others.
Peer Support
Provides guidance and feedback to help others strengthen knowledge/skills needed to accomplish tasks, solve problems, and perform effectively within the team.
Inspiring and Motivating Others
Fosters commitment and cohesiveness by facilitating cooperation and working as a team within the organization toward goal accomplishments. Work well with others, build consensus, and ensure cooperation to complete tasks and positive workflow.
Demonstrating Emotional Intelligence
Exercises self-leadership, self-awareness, and self-regulation; manages emotions so that they are expressed appropriately; leads others by showcasing adaptability, empathy, and social skills.
Acting with Integrity
Interacts with others in a way that is seen as direct and truthful; ensures confidence in individual and organizational motives and representations. Acts in a way that is consistent with personal and organizational values by keeping confidence, promises, and commitments. Clearly states goals and beliefs; informs people of their true intentions, does what they say they will do; follows through on commitments.
Being a Champion for Change and Innovation
Supports people in their efforts to try new things. Things creatively, generates novel and valuable ideas and uses these ideas to develop new or improved processes. Accepts new ways of doing things and adapts to change.
Communicating Effectively
Speaks and writes clearly, conveys information in a concise, organized, and logical manner. Is adept at tailoring the message to fit the interests and needs of the audience. Listens attentively and exercises tact, discretion, and diplomacy when interacting with members of the department and organization.
Promoting Diversity and Inclusion
Treats all people with dignity and respect. Demonstrates an open-minded approach to understanding people regardless of their gender, age, race, national origin, religion, ethnicity, disability status, or other characteristics. Challenges bias and intolerance. Develops all-inclusive groups in the realms of social interaction and communication. Shows respect for the beliefs of others; encourages and promotes practices that support cultural diversity; discourages behaviors or practices that may be perceived as unfair, biased, or critical toward people with certain backgrounds.
Physical Requirements
Requires sitting for long periods of time, also stooping, bending, standing, and stretching. Must have manual dexterity for typing and computer data entry. Able to work under a stressful environment, work independently, capable of making sound decisions, be detail oriented, alert, and self-motivated. Ability to push/pull up to 40lbs., carry and lift up to 20lbs.
Threshold Requirements
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These threshold requirements are required and completed yearly basis
- Annual Joint Commission mandatory education requirements, in-service and health requirements including attendance at new employee orientation
- TB/PPD Surveillance Program
- Maintenance of required professional licensing and/or certification(s).
This is not necessarily an extensive list of all responsibilities, skills, duties, requirements, or working conditions associates with the job. While this is intended to be an accurate reflection of the current job, management reserves the right to revise the job or require that other or different tasks be performed when circumstances change. I have reviewed these job requirements and verify that I can perform all essential functions of this position.
