Insurance Verifier

Job Type: Full-time
Location: Natchitoches Regional Medical Center
Department: NRMC WOUND CARE CLINIC

 

Description:

Position Summary

The Insurance Verifier for NRMC Wound Care Clinic must be a self-motivated person to perform office functions of insurance verification and Authorizations The associate verifies all insurance coverage for clinic patient visits, surgeries, and/or procedures in the clinic and at the hospital. The associate will be able to work without constant oversight and has the ability to multitask in a changing environment subsequent to the number of patients at one time. Will maintain the mission and core values set forth by Natchitoches Regional Medical Center.

Primary Responsibilities

Reasonable accommodations may be made to enable individuals with disabilities to perform the primary responsibilities.

1. Verifies all insurance and workers compensation benefits for all scheduled outpatient procedures.

2. Obtains pre-certification or prior authorizations for scheduled outpatient procedures.

3. Obtains PCP referrals required by third party payer.

4. Verifies eligibility for Medicare, Medicare HMOs, Skilled Payers, and Medicaid payers.

5. Verifies Skilled patients and obtains authorizations for skilled patients from skilled facilities.

6. Verifies and calls patients regarding their deductibles, co-pays, and payment arrangements.

7. Documents all pertinent and additional information obtained from the insurance company in the computer on the patient’s account and makes any necessary corrections.

8. Verifies that information on computer screen matches the information on insurance cards exactly.

9. Coordinates/schedules ancillary testing with other hospital departments. Obtains and verifies patient insurance information, to include pre-certifications and pre-authorizations for services and enters data in appropriate databases.

10. Assists in the registration process as required.

11. Provides insurance information to physicians as requested.

12. Actively participates in staff meetings to support key functions within the Center.

13. Participates in emergency and disaster situations.

14. Performs miscellaneous duties as deemed appropriate and when assigned by supervisor.

15. Maintains patient information in Meditech and IHeal.

16. Provides hospital billing office with charts when needed for billing.

17. Keeps all accounts updated with notes and scanning in Meditech and IHeal.

18. Will perform all duties above in Meditech and Iheal as required for pre-certifications authorizations and verifications.

19. Will float to other departments as necessary.

Competencies

1. Ability to read, write, speak, understand, and communicate effectively in English (other languages desirable)

2. Ability to concentrate when there are numerous interruptions.

3. Knowledge of third-party payers.

4. Knowledge of admission procedures.

5. Knowledge of automated systems and basic computer software.

6. Ability to type 50 wpm.

7. Ability to meet deadlines and work with time constraints.

8. Ability to use appropriate discretion in handling confidential material and information.

9. Good telephone techniques.

10. Ability to deal with public in a tactful manner.

11. Ability to perform detailed assignments, work accurately, follow directions and assesses priorities.

Supervisory Responsibility

None.

Requirements:

Required Education and Experience

1. High school diploma or GED required.

2. One-year admission experience required.

Preferred Education and Experience

1. Vocational training in office procedures preferred.

2. One to two years of college preferred.

3. Six months medical business office experience preferred.

4. Knowledge of medical terminology preferred.

5. Previous experience with insurance billing in a hospital, similar medical facility, or physician’s office preferred.