What are the responsibilities and job description for the Insurance Verification Representative - REMOTE position at Shared Services Center - Nashville?
Job Summary
The primary function of this position is to verify insurance for payment of procedures.
Essential Functions
- Interact with physician offices and patients in a timely courteous manner
- Verifies insurance benefits, eligibility, and pre-determination requirements for all scheduled patients
- Verify correct insurance package has been loaded into the patient's chart
- Review provider schedule in electronic medical record and obtain referrals for HMO patients; authorizations for procedures and radiology testing
- Review provider schedules in Hospital Radiology to look for and obtain authorizations for procedures and radiology testing
- Review the Authorization/Referral list in Athena and obtain/attach proper Authorizations and Referrals for pending appointments
- Utilize patient financial system and other computer systems to create the authorizations/referrals and attach to all relevant appointments
- Track and monitor authorizations/referrals to account for benchmark data
- Coordinates with the physician’s office when a required pre-determination has not been obtained
- Contacts patient in advance, notifies of estimated liability and payment options
- Utilize patient financial system and other computer systems to access and update surgery schedules, patient information for registration and up-front patient responsibility
- Answers telephone, questions, and returns calls in a courteous timely manner
- Assists and backs up other business office positions as needed
- Performs other duties as assigned.
- Complies with all policies and standards.
Qualifications
- H.S. Diploma or GED preferred
- 1-2 years customer service required
- 1-2 years health care / medical office experience preferred
Knowledge, Skills and Abilities
- To perform this job successfully, an individual should be proficient at working with computers and Google Suite. Experience working with patient financial systems, specifically patient financial systems (e.g., Athena, Availity, Tricare, ) preferred.
- A good understanding of medical terminology required
