Insurance Verification Clerk (Full Time)

Moss Social Services Insurance Verification Clerk

DESCRIPTION OF POSITION:

• Processes the entire caseload each month and routinely investigates payor sources/changes (Medicaid, pending Medicaid, and UCC often require daily verification). Requires frequent contact with patients, their families and payors.

RESPONSIBILITIES AND DUTIES:

• Independently and timely verifies coverage of all private insurance, HMO and workers' compensation.

• Adheres to state and federal insurance and patient confidentiality regulations and laws, including knowledge of insurance terminology, types of policies, and insurance rules and regulations of each.

• Obtains insurance schedule of benefits applicable, such as patient liability (deductible, co-pay and maximum out of pocket), maximum lifetime benefits and non-covered services

The above statements are only meant to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents may be requested to perform job-related tasks other than those stated in this description.

EDUCATION AND WORK EXPERIENCE

• High School graduate or equivalent.

• Previous work experience in healthcare or medical insurance environment.

• Basic office and keyboarding skills and the ability to use computer, printer, fax machine, scanner and calculator.

• Basic math skills for collection and reconciliation purposes.

• Proficient skills and understanding of Word and Excel.

• Ability to use multiple databases and Hospital specific software.

• Interpersonal skills to interact effectively with patients from various backgrounds in a professional, enthusiastic, courteous and caring manner.

• Complete understanding of time of service collections and collection goals. Basic knowledge of medical terminology and insurance/managed care program regulations.

Physical Demands/Work Environment

• Work requires a variety of physical activities including standing and walking for long periods of time, bending, stooping, and lifting.

• The work environment may be physically confining.

• Visual acuity is required for a variety of specific activities.

• Must have normal hearing or utilize adaptive hearing devices if duties require listening with a stethoscope to discern breath sounds, heart sounds, and bowel sounds.

• Ability to do shift work as required.

• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.