Insurance Verification Spec

Ranked #1 for Safety, Quality and Patient Satisfaction, Jupiter Medical Center is the leading destination for world-class health care in Palm Beach County and the greater Treasure Coast.

Outstanding physicians, state-of-the-art facilities, innovative techniques and a commitment to serving the community enables Jupiter Medical Center to meet a broad range of patient needs. Jupiter Medical Center is the only hospital in Palm Beach, Martin, St. Lucie and Indian River counties to receive a 4-star quality and safety rating from the Centers for Medicare & Medicaid Services (CMS).

Education High school graduate or equivalent Qualifications Enthusiastic, friendly, patient focused customer service skills. Exemplary communication skills, written and verbal – must be comfortable speaking to patients via phone and successfully communicate pertinent information. Professional, effective communication skills required to contact insurance companies to obtain patient benefits. Must be a team player with ability to collaborate interdepartmentally and with clinical staff. Capacity to multi-task with computer programs while providing patients the highest level of care and attention. Works well in a team environment to accomplish common tasks to solve problems and enhance the smooth and efficient flow of the department. Experience Minimum of 1 year experience with hospital insurance plans including Medicare, Medicaid, HMO’s, and PPO's. Excellent typing and computer skills. Familiarity with area managed care plans and contractual terms. Ability to self-direct and exercise independent judgment in situations requiring follow-up and discussions with clinical staff and/or other areas of Patient Access to ensure completion of required pre-arrival information to ensure enhanced customer service. Minimum of 1 year of specialized training in a health care setting with demonstrated knowledge of insurance verification and working knowledge of authorization and pre-certification process preferred. Familiarity with medical terminology. Position Summary The Insurance Verification Specialist will be responsible for delivering a dynamic customer experience to all customers and demonstrate a strong commitment to service excellence. The Insurance Verification Specialist initiates contact with insurance companies for verification of benefits. Utilizes electronic scheduling/pre-registration/financial systems, payer’s websites, and recorded calls to validate patient’s health coverage and benefits. Review and verify all insurance plans and confirm patient’s eligibility and benefits. Communicate with insurance carriers for insurance verification, obtaining patient benefits and/or follow up. Verify whether the plan coverage is Primary or Secondary, HMO, PPO or Commercial Carrier Insurance. Verify plan coverage including deductibles and co-pays and the status of payment requirements. Verify the out-of-network requirements/benefits for each patient. Verify insurance for emergency and walk-in patients as requested. Maintain proper insurance verification documentation in the patient’s medical record. Input or update any demographic, insurance information, referrals, patient management, documentation into electronic file. Contacts and communicates all applicable insurance deductible, co-pay, arrival and procedure information and instructions to the patient prior to arrival. Identify patient financial responsibilities and collect applicable payment. Maintains the confidentiality of patient’s records and any related work. Performs other duties as assigned.

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