Insurance Verifier/Patient Contact

Surgery Partners Houston , TX 77020

Posted 3 months ago

ESSENTIAL FUNCTIONS:

  • Ensure all records are maintained in absolute integrity and in compliance with applicable regulations and requirements.

  • Obtaining required referrals and authorizations via phone, fax, on-line, etc.

  • Review reports daily for patients requiring authorizations, pre-notification, and insurance benefit verification.

  • Obtaining retro-authorizations or updating existing authorizations in a timely manner.

  • Data entry in a fast-paced environment with high expectation on accuracy.

  • Updates the patient account with details of the insurance verification.

  • Coordinating with patients regarding their insurance benefits.

  • Identifies deductibles, co-pays, and self-pay accounts.

  • Notifying the appropriate staff members if treatment or service is denied.

  • Re-verify patients monthly for active, current insurance.

  • Assist manager and other staff with account questions when presented.

  • Perform other duties as assigned.

  • Relies on experience and judgment to plan and accomplish goals.

EDUCATION: High School, with 1-2 years experience in healthcare insurance billing and verification, collections and/or authorizations.

KNOWLEDGE:

  • Knowledge of clinic policies and procedures.

  • Knowledge of managed care contracts and utilization.

  • Knowledge of computer systems, programs and spreadsheet applications.

  • Knowledge of medical terminology.

  • Knowledge of CPT/ICD-10

SKILLS:

  • Skill in gathering and reporting claim information.

  • Skill in solving utilization problems.

  • Skill in written and verbal communication and customer relations.

ABILITIES:

  • Ability to work effectively with medical staff and external agencies.

  • Ability to identify, analyze and solve problems.

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Insurance Verifier/Patient Contact

Surgery Partners