What are the responsibilities and job description for the Insurance Verify Rep position at Turkey Creek Medical Center?
Job Summary
To complete accurate and timely verification of insurance for appropriate reimbursement. To coordinate information to the case management department and physician office to ensure pre-certification is obtained. To communicate with clients prior to service to establish payment expectations and initiate financial counseling. Ensures accurate liability is maintained on patient accounts.
Essential Functions
- Successfully works with physician offices to obtain required authorization for procedures from different prayers to prevent reschedules and cancellations.
- Effectively and efficiently verifies all insurance benefits for all services to determine insurance coverage.
- Efficiently maintains department records, reports and files as required, entering pre-certification numbers timely.
- Consistently refers uninsured and underinsured patients for financial assistance.
- Obtain and verify Eligibility and Benefits information for patients.
- Processes pre-registration documents, and forwards to appropriate department
- Interact with physician offices and patients in a timely courteous manner
- Verifies insurance benefits, eligibility, and pre-determination requirements for all scheduled patients
- Coordinates with the physician’s office when a required pre-determination has not been obtained
- Performs other duties as assigned.
- Complies with all policies and standards.
Qualifications
- Other Completion of two years of college level classes required
- H.S. Diploma or GED required
- Less than 2 years of customer service required or
- Less than 2 years of experience in an insurance related industry required
- 2-4 years insurance verification experience in an acute care hospital or physician practice group preferred
Knowledge, Skills and Abilities
- Prefer experience working with pre-certification. Insurance terminology is an asset.
- Ability to interact with patients, families, staff, management, physicians, representatives of insurance companies and other third-party payors, as well as the general public.
