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Insurance Verification Representative

Company: Surgery Partners
Location: Lubbock
Posted on: June 10, 2021

Job Description:

Shift: Full Time Days Monday - Friday 10a-6:30p

GENERAL SUMMARY

* Representative is responsible for verification of benefits and securing pre-certification or prior authorization numbers on applicable visits for patients at the Lubbock Heart Hospital. This includes the following: * Obtains treatment consents for minors and handles any irregularity that slows the registration process * Responsible for verification of insurance for patients who are pre-verified but present without insurance cards * Case Scheduling update * Pre-cert

ESSENTIAL FUNCTIONS

* Verify specific customer data during non-face-to-face transaction/s/ * Utilize additional data points for fraud detection * Comply with governmental policies * Initiate the pre-cert process * Informing all clinical departments of patient information * Up-date the case schedule and fax to all appropriate departments * Communicate with Director of Patient Accounts of any non-contracted insurance parties * Communicate with patient and doctor of admit procedure times * Notify all appropriate departments of any add on patients * Utilized excel spreadsheet for all schedules * Enter and update information in the HMS system concerning benefits

MINIMUM KNOWLEDGE AND SKILLS REQUIRED

* Knowledge of medical terminology and healthcare experience preferred * Excellent communication skills, verbal and written; interpersonal, and conflict resolution * Must be able to multi-task * Computer experience * Insurance billing experience preferred * Ability to conduct timely, impartial, and accurate interviews * Ability to document correctly and accurately * Knowledge of hospital office practices and procedures * Be able to interpret hospital and departmental policies and procedures accurately and implement them accordingly * Posses ability to work with hospital - based computer system * Know the definitions of fundamental computer terms related to applications software and desktop PC's * Know how to open, read, and respond to email * Know how to manage electronic files * Know how to print electronic documents and reports

MINIMUM EDUCATION AND EXPERIENCE REQUIRED

* High School Diploma * 1-2 years of college preferred * Minimum of 2 years customer service

LICENSURE AND CERTIFICATION

* None

ENVIRONMENTAL AND PHYSICAL REQUIREMENTS

* Works in temperature controlled environment. * Must to able to read, write and speak English fluently, have cognitive skills for math, reading, filing and sterile technique skills. Vision for near, mid-range, far and accommodation. Hearing for low, medium, and high pitch * Communication skills to deal well with employees, patients, families and physicians * Requires physical ability for standing, sitting, crouching, kneeling, frequent walking, reaching above head and below waist * Risks include exposure to blood and body fluids (high), contact with laser and chemicals, lifting of 30-50 pounds, and exposure to infectious disease

Keywords: Surgery Partners, Lubbock , Insurance Verification Representative, Other , Lubbock, Texas

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