Insurance Verification Representative I – Pre-Visit Services
Job Description:
• Perform pre-registration and insurance verification for inpatient and outpatient services.
• Follow scripted benefits verification and pre-certification format in the EMR and document results.
• Contact patients to confirm or obtain missing demographic information, quote/collect patient cost share, and provide appointment instructions.
• Assign insurance plans accurately and perform electronic eligibility confirmation.
• Complete Medicare Secondary Payor Questionnaire as applicable.
• Calculate patient cost share and arrange payment or collection via phone.
• Research patient visit history to ensure compliance with payor-specific rules (e.g., Medicare 72-hour rule).
• Communicate with physicians and case managers to resolve authorization or referral issues.
• Document benefit and authorization information in the standard EMR screens and notes as needed.
• Implement system downtime procedures when necessary.
Requirements:
• High School Diploma or GED required
• 1 or more years of experience in hospital Patient Access required
• Verbal and written communication
• Customer service orientation
• Basic math and PC proficiency
Benefits:
• PTO
• 401(k)
• Medical and dental plans
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• Perform pre-registration and insurance verification for inpatient and outpatient services.
• Follow scripted benefits verification and pre-certification format in the EMR and document results.
• Contact patients to confirm or obtain missing demographic information, quote/collect patient cost share, and provide appointment instructions.
• Assign insurance plans accurately and perform electronic eligibility confirmation.
• Complete Medicare Secondary Payor Questionnaire as applicable.
• Calculate patient cost share and arrange payment or collection via phone.
• Research patient visit history to ensure compliance with payor-specific rules (e.g., Medicare 72-hour rule).
• Communicate with physicians and case managers to resolve authorization or referral issues.
• Document benefit and authorization information in the standard EMR screens and notes as needed.
• Implement system downtime procedures when necessary.
Requirements:
• High School Diploma or GED required
• 1 or more years of experience in hospital Patient Access required
• Verbal and written communication
• Customer service orientation
• Basic math and PC proficiency
Benefits:
• PTO
• 401(k)
• Medical and dental plans
Apply tot his job
Apply To this Job