The insurance verification specialist is an experienced professional with extensive computer and insurance skills. The insurance verification specialist's role is to accurately validate patient insurance information to ensure the account has been properly authorized for service. All insurance specialists are to abide by the policies and procedures established by the department and hospital at all times.
JOB RESPONSIBILITIES
- Contacts payers to obtain benefits and eligibility prior to scheduled services.
- Determines necessity of authorization or notification for services being rendered.
- Initiates/verifies authorization using phone, fax and online websites.
- Understands and is proficient in securing appropriate codes to be used in the process of determining benefits and/or obtaining authorizations.
- Communicates all delays/concerns to both the patient and scheduling department.
- Demonstrates professionalism at all times with working with payers, physician office and all other customers.
- Processes all requests in a timely and efficient manner, being conscious of scheduling dates.
- Answers patient's requests or concerns in a professional and knowledgeable manner.
- Engages in department/hospital committees, QA programs and educational offerings.
- Follows email etiquette standards.
- Participates in training of new team members relating to insurance/payer requirements.
- Documents all accounts thoroughly on a consistent basis.
- Patient Registration team member acknowledges responsibility that their position may require working in other areas within the department at the direction of the department leadership.
- Attends department staff meeting, hospital-directed meetings and other required programs.
Education
Special Skills/Qualifications/Additional Training/Experience Required
- Must be able to read, write in, speak and understand English.
Shift hours: 8:30 a.m. - 5 p.m., Monday-Friday