What are the responsibilities and job description for the Insurance Verifier position at USPI?
North Central Surgical Center is a highly successful, Baylor Scott & White affiliated hospital located in Dallas, TX. We partner with the very best team members and medical staff in the area. We are a surgical focused hospital that performs over 12,000 procedures per year.
FACTS ABOUT NORTH CENTRAL: Opened in 2005, 14 Operating Rooms and 30 Medical/Surgical Patient Rooms. We are conveniently Located at Walnut Hill & 75 in the prestigious NorthPark area Specialties include: Orthopedics, Spine, General Surgery, Pain Management, Urology, GI/Endoscopy, Plastic, and Podiatry surgeries. Managed by United Surgical Partners International & Joint Commission Accredited
Job Description:
North Central Surgical Center is currently seeking a Full-Time Insurance Verifier in our Business Office Department.
- Retrieves patient information, verifying patient information is accurate (spelling of name, D.O.B., gender, etc.).
- Verifies patient insurance benefits by utilizing online websites or by contacting the carriers directly.
- Obtain authorizations from insurance companies/physician offices, pre-certification, requirements and referrals as needed.
- Ensure high cost implant/supply or equipment rental is included on authorization.
- Check insurance company approved procedure lists/medical policies.
- Calculates patient deductibles and/or copays based on contract interpretation of Managed Care Contracts and enter into the patient accounting system and spreadsheets provided.
- Contact patients regarding moneys due prior to date of surgery.
- Determine patient responsibility for payment based on contract and account reviews.
- Determine patient responsibility for cash payment based on reimbursement and account reviews.
- Fill out verifications sheet and upload to patient charts
- Assist front end staff in understanding verification of eligibility and/or patient responsibility.
- Answer incoming department call and assist patients with their benefit inquires & quotes
- Performs miscellaneous job-related duties as assigned.
Required Skills:
Requirements:
- Must be able to work 9:30-6pm shift.
- Minimum two years' experience in insurance verification & pre-certification for surgeries and medical terminology preferred.
- Strong knowledge of Government and State Medical plans.
- Strong Knowledge of Managed Care Contract.
- Communication skills: ability to effectively present information to patients, physicians, and other employees of surgery center.
- Proficient in computers and relevant software applications
- Basic math skills
- Provide exceptional customer service
- Cerner experience preferred.
Employment practices will not be influenced or affected by an applicant’s or employee’s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.
