Insurance Verification Specialist

JOB TITLE: Insurance Verification Specialist

St Joseph Center for Outpatient Surgery Benefits:

• Team Oriented Atmosphere
• Full Time and Part Time Profit Sharing twice a year
• 4 Additional Floating holidays per year
• Employer HSA contribution for HDHP
• 401K matching after 1 year of service
• Full Time/Part Time Medical, Dental, and Vision offered - 1st of the month after 30 days of employment

GENERAL SUMMARY OF DUTIES:

Ensures all records are maintained in absolute integrity and in compliance with applicable regulations and requirements. Responsible for obtaining required referrals and authorizations and verifying patient insurance benefits.

REQUIREMENTS:

• 1-2 years experience in healthcare insurance billing, verification, collections and/or authorizations preferred.
• Knowledge of computer systems, programs and spreadsheet applications.
• Knowledge of medical terminology.

RESPONSIBILITIES:

1. Act as liaison between patient, physician office, and insurance company to assist with
regards to financial responsibility

2. Verify patient insurance eligibility and benefits using technology tools, the telephone and
the internet to ensure compliance with the facilities policies and procedures

3. Coordinate with insurance providers and the physician office to obtain pre-authorizations.
Document these findings as instructed.

4. Obtain information for medical necessity determination and coordinate with the physician
office if additional information is needed

5. Communicate with patients to obtain any missing information necessary to achieve financial
clearance

6. Perform Benefit verifications on all patients

7. Cross train as required to assist with overflow responsibilities (Example: Scheduler, Patient
Estimate Notification, Receptionist)

8. Exhibit flexibility in work schedules and assigned tasks

9. Maintain minimal error rate

10. Maintain supplies and forms necessary in business office area.

11. Obtain and verify patient demographic and financial information

12. Participates in group meetings and /or various committees

13. Make suggestions on workflow improvements

14. Notify Supervisor of any issues

15. Maintains a positive attitude toward position and responsibilities

16. Assumes clerical duties and responsibilities as necessary. (Examples: case histories, chart
scanning, lunch coordination)

17. Responsible for any additional discussed and/or assigned duties from management.