What are the responsibilities and job description for the Insurance Verification Coordinator position at Riverside Health?
Newport News, Virginia
Overview
Responsible for verifying insurance eligibility and benefits, obtaining authorizations and providing patient estimates. Researches, follows-up and resolves open and pending authorizations in a timely manner. Monitors work queues, managing workload and completing accounts effectively.
What You Will Do
Education
Overview
Responsible for verifying insurance eligibility and benefits, obtaining authorizations and providing patient estimates. Researches, follows-up and resolves open and pending authorizations in a timely manner. Monitors work queues, managing workload and completing accounts effectively.
What You Will Do
- Obtains, validates and updates insurance information in the database, verifying eligibility and benefits. Utilizes effective and professional communication with patients, physicians' offices, and staff.
- Calculates and provides patient estimates and financial obligations. Ensures collection and/or notification of payment due for services to be rendered. Provides information and resources for patients regarding RHS financial assistance and self-pay processes.
- Verifies and/or obtains the necessary referral, authorization, or pre-certification prior to services being provided as required by payer.
- Researches and obtains missing information from provider practices, providing timely notification of issues, denials, and/or need for peer to peer.
- Monitors work queues, managing workload and completing accounts in a timely manner; follows current department workflows, staying up to date on changes.
- Utilizes Riverside Care Difference principles in all interactions and maintains strict confidentiality in all matters relating to PHI.
- Identifies issues and trends related to pending/denied authorizations, escalating to team lead and/or manager.
- Participates in continuing education and other learning experiences, sharing gained knowledge with team.
- Navigates online portals and systems to determine authorization requirements; catalogs and tracks authorization requests.
Education
- High School Diploma or GED, (Required)
- 1 year Revenue Cycle experience (Required)
- Certified Healthcare Access Associate (CHAA) - National Association of Healthcare Access Management (NAHAM) (Preferred)
