Location: 8100 S. Walker, Bldg. D, Oklahoma City, OK
Status: Full Time
Schedule: Monday-Friday, 8:30am-5pm (option to leave at 3pm Fridays)
Overall Responsibility: To verify benefits for all services provided by facility to ensure accurate reimbursement from patients and third party payers. Responsible to communicate with patients in a manner that demonstrated superior customer service and problem-solving skills.
Key tasks and responsibilities (essential functions)
Responsible to verify/pre-cert all insurance (primary and secondary) benefits at least one week prior to date of service or as soon as possible for late add-on cases.
Responsible to verify eligibility of all Medicare/Medicaid patients prior to date of service.
Responsible to complete insurance verification form for all cases (copy of forms attached for reference).
Responsible to fax Out-of-Network Notice to all appropriate carriers (copy of form attached for reference).
Responsible to enter all verification information into Patient Accounting Systemboth in verification section and comments.
Responsible for timely transition of paperwork to staff member providing estimate of charges and money due day of surgery.
Responsible to contact patients/responsible party for estimated deductible, copay, and/or coinsurance due day of surgery when Financial Counselor is unavailable. If Promissory Note is necessary, make comments in the Patient Accounting System according to agreement so that the appropriate paperwork can be completed for the patient to sign at the time of admitting day of surgery.
Must have the capability of making a minimum of 40-50 calls per day.
Record all contacts with patient/responsible party in Patient Accounting System.
Responsible to have a thorough working knowledge of all managed care contracts.
Responsible to keep verification/precert paperwork in date order for each facility to be matched up with charge ticket and later filed by date of service.
Responsible to provide back-up for staff verifying benefits when needed.
Responsible to report insurance carrier problems or concerns to management.
Follows regulations and guidelines protecting the confidentiality of health related information.
Responsible to comply with all USPI internal control practices and policies.
Responsible to perform other duties as assigned.
Licensure and Certification: None.
Experience required: Prefer experience with Patient Accounting System and handling patient benefits. Requires a high school certificate or equivalency.
Environmental and physical requirements - The employee works in a temperature controlled environment. Candidate must be able to read and speak English fluently, have cognitive skills for math, reading, computer skills, communication skills to deal well with the public (customers) as well as peers. Vision for near, mid-range, far and accommodation. Hearing for low, medium and high pitch. Job requires sitting for 70% of activities with minimal up and down activity. Job risk include exposure to computer for 6-7 hours per day with typing activities, lifting of 20-30 pounds maximum, potential for exposure to blood and body fluids (minimal), and exposure to infectious disease.
United Surgical Partners International