Job description
Duties:Retrieves patient information, verifying patient information is accurate (spelling of name, D.O.B., gender, etc.).
Verifies patient insurance benefits by utilizing online websites or by contacting the carriers directly.
Obtain authorizations from insurance companies/physician offices, pre-certification, requirements and referrals as needed. Ensure high cost implant/supply or equipment rental is included on authorization. Check insurance company approved procedure lists/medical policies.
Calculates patient deductibles and/or copays based on contract interpretation of Managed Care Contracts and enter into the patient accounting system and spreadsheets provided.
Contact patients regarding moneys due prior to date of surgery.
Determine patient responsibility for payment based on contract and account reviews.
Determine patient responsibility for cash payment based on reimbursement and account reviews.
Attach correct documentation to verification sheets and delivering to appropriate staff.
Assist front end staff in understanding carrier websites and verification of eligibility
Answer incoming department call and assist patients with their benefit inquires & quotes
Performs miscellaneous job-related duties as assigned.
Required Skills:
Minimum two year experience in insurance verification & pre-certification for surgeries and medical terminology preferred.
Communication skills: ability to effectively present information to patients, physicians, and other employees of surgery center.
Proficient in computers and relevant software applications
Basic math skills.
Strong knowledge of Government and State Medical plans.
Strong Knowledge of Managed Care Contract.
Provide exceptional customer service
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