Insurance Verification Specialist

Job Details

Job Location: Riverview Surgery Center - South Sioux City, NE 68776

RESPONSIBLE AND ACCOUNTABLE FOR:

• Verifying insurance coverage prior to patient arrival for evaluation and determining if the surgery center is in or out of network for patients.
• Completing insurance verification forms with correct benefit information, including deductible, co-pay and/or coinsurance.
• Providing estimates to patients on financial responsibility.
• Generate daily reports of evaluations to verify insurance is within network and obtaining referrals and prior authorizations from policies that require it.
• Answering patient phone calls promptly and addressing patient concerns.
• Obtaining proper insurance information and providing insurance information to patients.
• Serve as a backup for registration and scheduling.
• Comforts patients by anticipating patients’ anxieties; answering patients questions; responsible for keeping the reception area clean and organized.
• Protects patient’s confidentiality, making sure protected health information is secured by not leaving PHI in plain sight and logging off the computer before leaving it unattended.
• Answers the phone while maintain a polite, consistent phone manner using proper telephone etiquette.
• Obtains revenue by recording and updating financial information; recording and collecting patient charges; controlling credit extended to patients with prior approval; filing, collecting, and expediting third‑party claims.

REQUIREMENTS:

• Must have high school diploma and or equivalent.
• Working knowledge of insurance verification, benefits, prior authorization, medical necessity, and coordination of benefits.
• Must be able to pay attention to details and accurately input data.
• Must have knowledge but not limited to – medical terminology, Word, Excel, Outlook, PC, telephone skills, Customer Service, Time Management, Organization, Attention to Detail, Multi‑tasking, Flexibility, and Professionalism.
• Must be able to perform each essential duty satisfactorily.
• Ability to read and interpret documents such as physician orders, safety rules, operating and technical instructions, and policy and procedures manuals. Ability to create routine reports and correspondence.