Insurance Verification - Full-time
**STATED SALARY IS STARTING PAY RANGE**
POSITION SUMMARY: Responsible for obtaining pre-authorized benefit and eligibility information prior to the scheduled procedure. In addition, this position monitors the patient account and, when needed, advocates for the patient with the insurance companies.
QUALIFICATIONS:
Education: A high school diploma or equivalent is required.
Experience: Previous experience in medical business office preferred.
Physical:
Must be able to Sit, stand, walk, and perform keyboard operation continually
Occasionally bend, climb, reach overhead, carry/push or pull 1-10 pounds, grasping/squeezing
Rarely stoop, kneel, crouch, lift, carry, push or pull 11-15 pounds
Must be able to speak and hear normal auditory levels
Mental:
Must have excellent communication skills and ability to interact with a diverse population professionally
Ability to effectively interact and communicate with all levels within Bend Surgery Center as well as external contacts, i.e. vendors, patients, physicians and visitors
Mathematical skills: Basic mathematical skills required.
Language skills: Ability to understand, read, write, and speak English. Ability to successfully and effectively write business correspondence, present information, respond to questions, and professionally interact with managers, employees, patients, vendors, and the general public.
Job skills:
Must be computer literate with strong knowledge of Microsoft Office products
Must have knowledge of and ability to perform basic office skills
Must have comprehensive knowledge of reimbursement and collection procedures
Strong experience with 10-key and accurate typing skills
JOB RELATIONSHIPS: Is responsible to the Business Office Manager. Does not supervise other employees.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
Verifies patient information, insurance benefits and insurance requirements prior to patient surgery
Follows up with insurance company regarding prior-authorizations, referrals, benefits and eligibility
Completes and files facility fee estimate according to benefits and established process
Handles incoming calls regarding patient insurance questions prior to procedure
Contact patient regarding patient financial responsibility prior to procedure
Assists the patient with questions regarding benefits
Maintains patient records to ensure accuracy
Maintains strictest confidentiality and adheres to all HIPAA guidelines and regulations
Manages proper submission of documents in a timely fashion
Determines if the patient can be seen at the ASC based on their insurance coverage
Updates the upfront collections log as needed
Works with the Physician practice to coordinate benefits and upfront collections where needed
Completes verification in a timely manner to allow time for patient liability calls
Makes arrangements for patient payments based on center guidelines
Attends all required education and in-services
Adheres to safety policies and practices good body mechanics and ergonomics
Follows all rules and regulations for PHI and HIPAA protections of patient information
Follows all policies and procedures, including, but not limited to, attendance, timeliness, and safeguarding confidential information
Performs other duties as assigned
ESSENTIAL VALUES, CODES OF CONDUCT
Demonstrates knowledge of and adheres to the Code of Conduct
Strong ethical and moral character references
Attitude that is caring, respectful, sensitive, tactful, compassionate, empathetic, and tolerant exhibiting a positive, professional demeanor to peers, patients, physicians and visitors
Works well with others – a team player
Exhibits high level of integrity
Must be organized, flexible and versatile with the ability to function effectively in stressful situations
Must be able to accept and profit from instruction and constructive criticism and follow through to effect change
Must be able to recognize limitations and seek help or advice as needed
WORK ENVIRONMENT:
Days and hours of work vary to meet patient or center needs
The Center is a well-lit, ventilated and climate-controlled environment
Ability to work with office equipment, some of which will have moving parts
Noise level is usually quiet to moderate
Work in close proximity to co-workers