AddressThe Insurance Verification Representative ensures that patient demographics, insurance information, and insurance benefits are obtained and validated with the payer. This information is to be accurately reflected within the EMR for BHC appropriate communications with the payer, patient, and ordering provider must be professional and documented. In addition to the timely execution and review of benefit information, estimates are created in accordance with state regulations regarding transparency and no surprise billing. The Insurance Verification Representative works closely with case management/utilization review, payers, provider practices, patients, scheduling, financial counselors, and registration to ensure proper financial clearances.
Responsibilities
- Obtains information from patient health insurance or managed care identification card.
- Completes all registrations in a professional, accurate and customer-oriented timely manner.
- Performs and delivers excellent customer service to all customers - patients, physicians, ancillary service lines, and payers.
- Maintains Baptist Health Care goals of scheduling, registration accuracy, insurance verification, pre-registration, pre-certification, up-front collections, and other healthcare industry standards or trends.
- Meets current regulatory and compliance standards, such as HIPPA and Identity Theft "Red Flag Rules" by ensuring all patients are properly identified prior to scheduling.
- Follows the hospital exposure control plans/bloodborne and airborne pathogens.
- Reviews and updates the patient's account to ensure the organization has accurate and current information to process claims and to obtain payment including complete documentation of benefits, authorization information, and patient financial responsibility including other insurance changes as required.
- Tracks productivity and provides cumulative reports on a daily, weekly, or monthly basis, as required by department.
- Attends all required safety training programs and can describe his/her responsibilities related to general safety, department/service safety, and specific job related hazards.
Qualifications
Minimum Education
- High School Diploma or Equivalent Required
Minimum Work Experience
- 6 months Customer service experience Required
- 6 months Previous registration and/or scheduling experience Preferred
- 6 months Third party and self-pay collection experience Preferred
Required Skills, Knowledge and Abilities
- Demonstrates competency in working in teams and ability to effectively communicate with all levels.
- Demonstrates respect and regard for the dignity of all patients, families, visitors and fellow employees to ensure a professional, responsible, and courteous environment.
- Provides excellent customer service to internal and external contacts.
- Excellent written and oral communication skills.
- Proficient in data entry computer skills.
- Ability to function in high paced, often stressful environment and/or circumstances while maintaining a respectful, caring and professional manner.
- Ability to deal appropriately with confidential information.
- Able to function effectively with frequent interruptions.
About Us
Baptist Health Care is a not-for-profit health care system committed to improving the quality of life for people and communities in northwest Florida and south Alabama. The organization includes three hospitals, four medical parks, Andrews Institute for Orthopaedic & Sports Medicine, and an extensive primary and specialty care provider network. With more than 4,000 team members, Baptist Health Care is one of the largest non-governmental employers in northwest Florida.
