What are the responsibilities and job description for the Insurance Verification Specialist position at Rochester Ambulatory Surgery Center?
Job Description
Job Description
JOB SUMMARY :
The Insurance and Verification Specialist processes patient information for billing purposes. Will verify patient insurance information and authorizations.
DUTIES AND RESPONSIBILITIES :
- Confirms primary and secondary payers, verifies insurance identification numbers and prior approval numbers, obtains correct insurance coverage, and notifies Medical Receptionists of patient insurance co-payment due by contacting insurance companies, doctors’ offices and patients via telephone. Verifies insurance coverage for local HMOs electronically.
- Oversees the review of scheduled patient appointments for self-pay patient accounts to ensure arrangements for pre-payment, and assists in the daily review of preliminary insurance information to determine ASC coverage.
- Submits claims to various payers daily.
- Reviews, researches and resubmits with required documentation denied and problem claims daily.
- Prepares, reviews, and mails self-pay statements monthly or as needed.
- Monitors complete self-pay receivables and write-offs delinquent receivables and sends data to external collection agency.
- Responds to patients’ billing questions by telephone and / or in person.
- Transmits billing information to third party payers electronically and follow-up to ensure information was received; resubmits information, if necessary.
- Reviews the accounts receivable aging and evaluates claims 60 days and older for collection procedures and makes appropriate telephone calls to insurance companies / responsible parties for collection or resolution.
- Performs such similar, comparable, or related duties as may be required.
- Ensures a pattern of reliability in performing the “Essential Duties” of this position through the maintenance of a satisfactory attendance record.
- Other duties, as assigned
EDUCATION :
High School graduate or equivalent. Healthcare experience preferred.
PERSONAL QUALIFICATIONS :
Excellent physical and mental health.
Personality traits capable of enhancing team spirit.
Demonstrates leadership ability.
Demonstrates ability to communicate effectively.
Strong attention to detail.