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Insurance Verification Specialist

Company: Vail Health
Location: Vail
Posted on: June 9, 2021

Job Description:

POSITION PURPOSE:
Acts as a liaison between patients, providers, and insurance companies to ensure appropriate data collection, compliance with third party payers and federal and state regulations. Obtains benefits, eligibility and preauthorization, and acts as a financial counselor when explaining insurance and payment options.
ESSENTIAL JOB FUNCTIONS:
  • Works closely with physician schedulers and the OR Manager to ensure accuracy of the schedule, accuracy of data entry and troubleshoots to obtain any missing information.
  • Demonstrates a high working knowledge of managed care contracts and major third party payers when verifying insurance benefits, eligibility and prior authorization requirements for scheduled patients.
  • Notifies patients of estimated liability and acts as a financial counselor regarding insurance and payment options. Ensures compliance with surgery center collections policies.
  • Screens patients for Financial Assistance Program eligibility. Clearly documents insurance details, required payments and any additional information to assist patient access and collections.
  • Coordinates with the physicians office when prior authorization requirements are not in place.
  • Works closely with other departments to ensure that the process is running as smoothly and efficiently, including timely notification of add-ons and cancellations. Ensures the patient access and clinical staff are aware of any potential insurance related delays.
  • On an as needed basis will assist and back-up other front office staff positions and may assist with orientation of new hires.
  • Demonstrates dedication to customer service such as assistance with telephone calls, giving directions, and providing general facility information. Interacts with external and internal parties with courtesy and sensitivity.
  • Actively participates as a collaborative member of the department team by communicating constructively, identifying business office and interdepartmental problems, and resolving conflicts appropriately.
  • Responsible for coordinating with other staff members and schedulers when out of the office to ensure insurance activity continues seamlessly.
  • Role models the principles of a Just Culture and Organizational Values.
  • Perform other duties as assigned. Must be HIPAA compliant.
MINIMUM QUALIFICATIONS:
  • One year healthcare experience required or one year of related experience required.
  • Medical terminology and working knowledge of surgical equipment (machines, implants, etc.) helpful.
  • Knowledge of ICD-10 and CPT coding desirable.
Education:
Bachelors degree preferred with emphasis in business and/or health sciences

Location: Vail Health 7122 VAIL VALLEY SURGERY CENTER
Schedule: Full-time (Year Around), Days

Keywords: Vail Health, Vail , Insurance Verification Specialist, Other , Vail, Colorado

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