Verification Specialist

Job Description

Job Description

Underneath the supervision of the Center Leader or Office Manager, responsible for areas such as insurance verification, scheduling of surgical procedures, billing / coding / accounts receivable, accounts payable records or transcription of operative procedures. Promotes a favorable image of the Center to physicians, patients, insurance companies, and the general public.

QUALIFICATIONS :

High School Diploma or GED

One (1) year of experience, preferably in an Ambulatory Surgery Center (ASC)

Experience in Endoscopy / Multi- specialty / Ophthalmology / ASC

Ability to speak and understand the English language

Strong ethical and moral character references

Basic computer skills

ESSENTIAL DUTIES AND RESPONSIBILITIES :

Reviews and maintains records to ensure accuracy

Enters data electronically to process patient information

Maintains all patient records

Abstract clinical information from a variety of medical records

Maintains strictest confidentiality and adheres to all HIPAA guidelines and regulations

Manages proper submission of documents in a timely fashion

Attends in-services, seminars, and webinars for additional education and performance improvement

Reviews insurance benefits and insurance requirements on all new patients prior to surgery

Verification of medical benefits, which includes contacting private insurance companies, Medicare,

and Medicaid to obtain benefit information (phone or electronically)

Determines if the patient can be seen at the ASC based on their insurance coverage

Updates the upfront collections log as needed

Meets with patients regarding their insurance benefits

Works with the Physician practice to coordinate benefits and upfront collections where needed

Completes verification in a timely manner to allow time for patient liability calls

Contacts patients with patient liability information

Makes arrangements for patient payments based on center guidelines

Strong experience with 10-key

Types a minimum of 40 wpm

Strong knowledge of Microsoft Excel and Outlook

Attends all required education

Regular and predictable attendance

Performs other duties as assigned

Cognitive Skills

Exhibit mental alertness for quality decision making and exercising good judgment

Ability to multi-task effectively, efficiently, accurately, and with attention to details

Ability to recognize / define problems, collect data / facts, draw valid conclusions, and correct errors

Ability to interpret instructions in a variety of forms and deal with abstract and concrete variables

Communication

Ability to effectively communicate patient care needs and significant information to healthcare team to

promote continuity of patient care

Ability to respond to questions and professionally interact verbally and / or written with managers, co-workers,

patients, and the general public

Teamwork

Work well with others – be a team member

Report observed or suspected safety violations, hazards, and policy / procedure non-compliance to Safety Officer

or other designated person, following the Chain of Command

Participate in staff meetings, in-services, and continuing education as required

MATHEMATICAL SKILLS :

Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions,

decimals, and percentages

LANGUAGE SKILLS :

Ability to understand, read, write, and speak English, if bilingual Center, bilingual language is required. Ability to read,

analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental

regulations. Ability to successfully write business correspondence. Ability to effectively present information,

respond to questions, and professionally interact with healthcare team, clients, vendors, and the general public.

REASONING ABILITY :

Demonstrates an ability to recognize and define problems, collect data, establish facts, draw valid conclusions,

correct errors. Ability to understand and interpret basic financial data.

Ability to interpret a variety of instructions

in a variety of forms and dealt with abstract and concrete variables.

PHYSICAL DEMANDS :

Ability to stand and walk for 6-8 hours per day

Ability to exert maximum muscle force to lift, push, pull, or carry objects up to 50 pounds in weight

Ability to use abdominal and lower back muscles to support part of the body repeatedly or continuously without

giving out” or fatiguing

Ability to perform physical activities that require considerable use of your arms and legs and moving your whole

body, such as climbing, lifting, balancing, walking, stooping, and handling of materials.

Ability to keep your hand and arm steady while moving your arm or while holding your arm and hand in one

position

Ability to exert yourself physically over long periods of time without getting winded or out of breath

Ability to quickly respond (with the hand, finger, or foot) to a signal (sound, light, picture) when it appears

Specific vision abilities for close and distance vision, color vision, peripheral vision, depth perception, and ability to

adjust focus

WORK ENVIRONMENT :

Days and hours of work may vary to meet patient needs

The Center provides preoperative beds, procedure rooms, and post-procedure beds

The Center is a well-lit, ventilated and climate controlled environment. The Center may require decreased lighting to

meet patient care needs, such as laser rooms and some OR / Procedure rooms

Staff will work with medical and office equipment, some of which will have moving parts

Noise level is usually quiet to moderate

Staff may have exposure to blood and other potentially infectious body fluids and materials or toxic chemicals and

cleaning solutions

The Center procedure rooms are often small, and due to equipment may have little room to work around and may

necessitate reaching, pulling, pushing

Staff will work in close proximity to patients and co-workers

Effective November 1, 2021, AMSURG’s Vaccination Policy requires all teammates, including clinicians and independent contractors, to be fully vaccinated for COVID-19 as a condition of employment or engagement. Regardless of position, all new hires must submit proof of vaccination and or obtain an approved medical or religious exemption as a condition of employment. This policy is designed to protect the health and safety of our patients, communities and each other.

We do not discriminate in practices or employment opportunities on the basis of an individual's race, color, national or ethnic origin, religion, age, sex, gender, sexual orientation, marital status, veteran status, disability, or any other prohibited category set forth in federal or state regulations.