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DescriptionInsurance Verifier AdventHealth Fish Memorial Orange CityLocation Address: 1061 Medical Center Dr. Orange City, FLWork Hours/Shift:Full Time, DayYou Will Be Responsible For:
Gathers required information from the scheduling module to ensure all scheduled patients are authorized prior to date of service.
Reviews the Denial/Rejection list from Denials Management and determines cause for denials, provides Patient Accounting with documentation if the denial is inappropriate, educates the staff concerning errors that caused the denial, communicates with Managed Care department regarding discrepancies in information obtained from contracted insurance carriers.
Ensures accurate demographics and proper identification of each patient by verifying social security number, date of birth and spelling of name.
Determines proper financial class and insurance codes by requesting insurance information and assigning current code as specified in pneumonic index.
Makes initial attempt for all scheduled visits to obtain precert/authorization/referral prior to date of service by calling appropriate insurance or by verifying electronically whenever appropriate.
QualificationsWhat You Will Need:KNOWLEDGE AND SKILLS REQUIRED:
Must have typing skills of at least 40 wpm.
Proficiency in the performance of basic math functions, capability to communicate professionally with an acceptable use of English and spelling.
Most work is repetitive, and new situations arise frequently, which require good judgment in the application of available policies and procedures.
Must use good judgment and take initiative to resolve immediate or urgent problems.
Must be proactive in developing processes to improve efficiency and services of the Verification area.
Must be able to act quickly when emergency situations occur, such as fire, security or disaster.
Must be able to coordinate multiple projects at the same time and maintain professional demeanor.
Must be a quick learner and have excellent memory in order to process accounts in a timely manner.
EDUCATION AND EXPERIENCE REQUIRED:
A high school education or equivalent is required.
An Associates Degree is preferred.
College courses or the equivalent in computer programs (Outlook,Excel, Word, Power Point) is encouraged.
One year of registration or scheduling experience in a Health Care setting is preferred.
Job Summary:Position is under the direct supervision of PFS Supervisor and PFS Manager. Obtains pre-cert and/or authorizations, performs eligibility verification, documents benefits in hospital computer system, obtain copy information of supporting documentation or refers patient to Financial Counselor if appropriate. Responsible for insurance verification process for Scheduling Outpatients, Inpatients and Same Day Surgery patients as assigned. Position has direct financial impact on reimbursement and denial management process. Supports Patient Registration area, performing the duties of an Admitting Representative as needed.This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, age or disability/handicap with respect to recruitment, selection, placement, promotion, wages, benefits and other terms and conditions of employment.
