Navigant Cymetrix unites the strengths of four category-leading companies to address the complexities of today's healthcare system. We design, develop and implement integrated, patient-centered solutions for sustained improvements in performance and profitability, working collaboratively across a spectrum of customers that encompasses hospitals, health systems, physician practice groups and payers.
The Insurance Verification Specialist will identify, verify, document and post patient liability for Managed Care Payment Review (MCR) clients. This position will also perform all related job duties as assigned.
Essential Job Functions
Verify the type of Health Plan coverage in Proclaim and make the necessary corrections with linking accounts
Verify patient liability as determined by the Health Plan/Payer
Reconcile accounts based on contract terms
Document all account activity performed
Confirm the insurance MCO as listed in Proclaim
Close accounts in Proclaim
Duties and Responsibilities
Review patient payments and patient liability to verify consistency with payment terms of corresponding contract between client, payer and the priced underpayment.
Balance the patient responsibility and insurance payment to the priced underpayment.
Confirm contracts and close accounts
Maintain accurate, timely and thorough documentation regarding verification and account activity.
Perform timely and effective verification efforts.
Maintain departmental databases.
Produce periodic status reports.
Assist departmental staff with assigned tasks.
Maintain confidentiality of company, client and patient information.
Maintain confidentiality of all private health information and contract terms.
Perform all activities within the limitations of applicable laws and regulations.
Maximize verification efforts of patient accounts.
Perform all responsibilities in a professional manner and consistent with the instructions provided by the client.
High School or GED equivalent minimum
Minimum of 6 months of work experience in healthcare billing/collections or claims processing environment.
Excellent organizational and analytical skills.
Strong interpersonal and verbal and written English language skills sufficient to interact effectively with both internal and external contacts.
Basic accounting and math skills.
Detailed and able to handle multiple tasks concurrently.
Able to meet deadlines and perform with minimal supervision.
Computer keyboard and word processing skills sufficient to meet production and quality standards.
Constantly operates a computer and other office equipment to coordinate work.
Usually remains stationary for most the day.
Frequently communicates with clients and coworkers and must be able to share information effectively.
Occasional stooping, reaching or kneeling may be necessary to reach into overhead or low cabinets.
Regularly uses close visual acuity and operates computer equipment to prepare and analyze and transmit data.
Generally, works in an office environment.
Navigant Cymetrix is an Equal Employment Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, citizenship status, military status, protected veteran status, religion, creed, physical or mental disability, medical condition, marital status, sex, sexual orientation, gender, gender identity or expression, age, genetic information or any other basis protected by law, ordinance, or regulation.
Navigant will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.
Navigant Consulting, Inc. (NYSE: NCI) is a specialized, global professional services firm that helps clients take control of their future. Navigant's professionals apply deep industry knowledge, substantive technical expertise, and an enterprising approach to help clients build, manage and/or protect their business interests. With a focus on markets and clients facing transformational change and significant regulatory or legal pressures, the Firm primarily serves clients in the healthcare, energy and financial services industries. Across a range of advisory, consulting, outsourcing, and technology/analytics services, Navigant's practitioners bring sharp insight that pinpoints opportunities and delivers powerful results. More information about Navigant can be found at navigant.com.