Part Time Insurance Verification Clerk

Gastroenterology and Associates in Olympia is seeking a Part Time (non-benefited) Insurance Verification Specialist!

JOB SUMMARY

Verifies insurance coverage based on information provided by physician offices at the time of

scheduling. Contacts patient to gather additional information, if needed, as well as to notify them of

their financial responsibility prior to the scheduled date of service.

Reviews financial obligation with patient and authorized party following USPI's Surgicares program or

any other program established by the company. Pre-qualifies third party coverage of scheduled

procedure(s). Actively coordinates with materials management regarding required implants, equipment

and/or supplies needed for scheduled cases in order to calculate allowable and patient responsibility

accurately.

Follows all policies and procedures.

THESE DUTIES ARE IN ADDITION TO ANY OTHER DUTIES ASSIGNED TO THE INDIVIDUAL BY

MANAGEMENT.

Required Skills:

ESSENTIAL JOB DUTIES AND RESPONSIBILITIES: Includes the following. Other duties may be

assigned by management.

Communication Responsibilities to include, but not limited to:

Provides payment arrangement documentation for surgical procedures to appropriate

individuals

Maintains current materials, such as Care Credit brochures and forms, MedDraft forms, etc. for

patient education, review and signature.

Discusses documentation with patient and family member confirming instructions are

understood and questions answered

Answers patient and authorized party's questions and refers questions to healthcare

professionals when appropriate

Communicates pertinent information from physician, support staff, insurance companies and

other significant parties to the patient

Reviews pre-qualification for third party payer before date of scheduled admission and contacts

payer to ensure facility is covered for pre-certifications and pre-qualifications.

Verify Insurance Benefits and Determine patient responsibility based on Insurance Contract

Verifies insurance payments and billing packets for central billing office

Counsels patients about facility charges, insurance coverage, and patient responsibility.

Discusses financial obligations with the patient or authorized party, explaining fees and

reimbursement process

At patient request, provides a written explanation of estimated fee schedules prior to surgery

and documents it in the patient's medical record

Determines patient qualification for coverage by third party payer and informs patient or

authorized party of status. If patient is not covered, arranges for payment following company

designated program

Assists in planning a payment schedule for the patient, if appropriate

Completes data entry of patient cost sheets, insurance verification forms, payment arrangement

forms completely and accurately and assures any forms needing patient review and signature

are provided to registration prior to the date of service

Obtains demographic information / surgical checklists from scheduling

Places calls to offices as needed to obtain and to ensure timely processing of verification

Performs insurance verification process and completes it with thorough documentation of

benefits, patient information and any other financial information obtained.

Enters complete and accurate information into computer system, such as on verification button,

in comments, in registration module, etc., so that mistakes are avoided, claims are clean and all

information is available to all appropriate personnel

Verifies that procedures scheduled are procedures covered when performed in an ASC by the

payer by checking Medicare and Medicaid fee schedules.

Uses all calculators available such as Medicare, workers compensation, out of network, etc.,

accurately

Calculates allowable as directed by management for all cases.

Notifies management for approval when an out of network case, charity case, courtesy case,

financial hardship case, or self-pay case is received prior to contacting patient.

Cross cover for patient check in at the front desk for vacations and sick calls when needed.

Reports daily to management about current status of projects or workflow

Performs all other duties as assigned by management

KNOWLEDGE SKILLS AND OTHER REQUIREMENTS:

Ability to handle confidential information

Ability to set priorities and to work independently

Ability to interact in a positive manner with co-workers, supervisor and other facility employees

Ability to handle multiple tasks

Ability to enter data into computer, file large amounts of paper and use office equipment

Knowledge of how to access benefits from various sources such as phone, person, websites

Ability to interpret benefits in order to convey to patient and to calculate allowable

Ability to use discretion in dealing with the public

Strong interpersonal skills

Ability to communicate patient benefits and payment options effectively and professionally

Ability to calculate allowable and patient responsibility accurately

Knowledge of medical terminology

The above statements are intended to describe the general nature and level of work being performed by

individuals assigned to their job. They are not intended to be an exhaustible list of all responsibilities,

duties, knowledge, skills and abilities required of individuals so classified.

TOTAL EDUCATION, VOCATIONAL TRAINING AND EXPERIENCE

High school diploma or equivalent. Previous experience in healthcare facility business office is desired.

Computer, office equipment skills are required. Medical terminology required.

Benefits

USPI offers the following benefits, subject to employment status:

• Medical, dental, vision, disability, and life insurance

• Paid time off (vacation & sick leave)

• 401k retirement plan

• Paid holidays

• Health savings accounts, healthcare & dependent flexible spending accounts

• Employee Assistance program, Employee discount program

• Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance.

Salary: $20.80-$26.65 per hour

Employment practices will not be influenced or affected by an applicant's or employee's race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.

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