What are the responsibilities and job description for the Financial Clearance / Insurance Verification Specialist position at Southwoods Health?
Financial Clearance / Insurance Verification Specialist
Southwoods Health is hiring a Financial Clearance / Insurance Verification Specialist to work at The Southwoods Executive Centre in Boardman, Ohio. This position is responsible for accurately verifying patient insurances, confirming benefits and eligibility, ensuring an authorization is secured for the procedure to be performed, and calculating and communicating the patient responsibility to ensure timely payment will be made for the services rendered.
Essential Duties :
- Verify all insurance coverage, workers' compensation insurance, accident insurance, and state programs and determine patient's responsibility if applicable
- Obtain or confirm precertification number is secured
- Determine patient qualification for coverage by third-party payer and inform supervisor if an authorization isn't secured within 72 hours of the scheduled procedure date
- Completely and accurately document benefits, eligibility, and authorization for third-party payer before date of scheduled admission
- Follow all federal, state, and regulatory guidelines to maintain compliance
- Ensure patients are educated and prepared to make a deposit on any out-of-pocket expense
- Stay abreast of insurance requirements for prior authorization and medical necessity
- Maintain awareness of in and out of network status and ensure this is also communicated to the patient
- Ensure all processes at responsible physician practice maintains compliance with all regulatory agencies
- Perform other duties as assigned
Qualifications :
Full-time. Monday-Friday 8 : 30am-5 : 00pm.
At Southwoods, it's not just about the treatment, but how you're treated. #SWH
www.southwoodshealth.com
