Insurance Verification Specialist
City/State: Fredericksburg, Virginia
Category: Patient Services
Position Hours: 40Apply
Position Shift: Day (United States of America)
Job Requisition Number: R-2975
Job Department: 4906031 MWMG-Orthopedics
Job Posted Date: Apr 27, 2021
Start the day excited to make a difference…end the day knowing you did. Come join our team.Job Summary:
The Insurance Verification Representative obtains insurance authorization and/or verification for patients who require services at Mary Washington Healthcare.
Essential Functions & Responsibilities:
- Monitors reports or work queues in accordance with the insurance verification and authorization processes to ensure timely notification and insurance verification processing. Processes insurance verifications through various systems and websites.
- Utilizes multiple resources to verify eligibility, coverage, and authorization/pre-authorization requirements have been met. Confirms authorization is appropriate for scheduled service(s), data span, facility, etc.
- Places clinical documentation submitted with the order into the patient chart for securing insurance authorization as necessary.
- Maintains compliance and appropriate assignment (primary, secondary, etc.) for coordination of benefits. Initiates admission notifications to payers. Communicates patient/guarantor financial responsibility, co-pay, deductible and/or self-pay deposits.
- Secures accounts for services in a timely manner. Communicates patient waivers and Advanced Beneficiary Notifications to appropriate customers, registration areas, and clinical departments.
- Reviews patient data for accuracy and completeness of demographic and insurance information and reviews and makes appropriate changes when needed. Reports audit findings and identifies and recommends process improvements within the registration and insurance verification processes.
- Understands the workflow of the entire patient access process and works with the team to ensure efficient workflow management.
- Performs other duties as assigned.
- High school diploma or equivalent required.
- Healthcare, registration, and insurance experience required.
- Familiarity with diagnostic and/or surgical procedures in a hospital setting required.
- Ability to explain benefits details and authorization requirements to internal and external customers required.
- Proficient computer skills relevant to the position required. WorkDay, Word and Excel preferred.
- Strong verbal and written communication skills required.
- Strong customer service and telephone skills required.
As an EOE/AA employer, the organization will not discriminate in its employment practices due to an applicant's race, color, religion, sex, sexual orientation, gender identity, national origin, and veteran or disability status.