Insurance Verification

Position Summary:
Under the direction of the Business Office Manager, Responsible for the timely pre-certification, authorization, and verification of insurance coverage for pre-admissions, admissions, and specified procedures. The insurance verification specialist will obtain accurate patient demographic and financial information to assist in the patient registration upon arrival.  This professional also serves as a valuable resource to patients, providing them with pertinent information regarding their insurance coverage; and works with patients to explain coverage amounts provided by their insurance policy. The insurance verification specialist also helps patients arrange payment for services that are not covered by their insurance companies inclusive of different financing options as defined by policy.
Essential Job Functions
• Perform pre-registration and insurance verification within 24 hours of receipt of reservation/notification for both inpatient and outpatient services
• Print procedure schedules daily 
• Follow –up on schedules daily for patient add ons
• Follow scripted benefits verification and pre-certification format
• Contact physician offices to resolve issues regarding prior authorization or referral forms
• Assign insurance mnemonics accurately
• Perform electronic eligibility confirmation when applicable and document results
• Research patient visit history to ensure compliance with payer specific payment window rules
• Calculate patient cost and be prepared to collect via phone or make payment arrangement
• Contact patient via phone (with as much advance notice as possible, preferably 48 hours prior to date of service) to confirm or obtain missing demographic information, quote/collect patient cost share, and instruct patient on where to present at time of appointment
• Communicates with hospital based Case Manager as necessary to ensure prompt resolution of pre-existing, non-covered, and re-certification issues
• Meets/exceeds performance expectations and completes work within the required time frames
• Implements and follows system downtime procedures when necessary
• Other duties as assigned

Qualifications/Requirements
• High school diploma, Post-secondary education preferred
• 2 years related experience and/or training
• Operational knowledge of computers
• Strong written & verbal communication skills
• Strong telephone etiquette
• Works successfully in a cross-functional team environment
• Practical problem solving skills
• Dependable attendance
• Able to work independently with minimal direct supervision
• Able to prioritize multiple tasks
• Strong organizational skills

Physical Abilities
• Reaching, bending, stooping & stretching
• Able to lift 10 pounds from ground level without assistance
• Visual acuity

Seven paid holidays
Sick and vacation after waiting period
Health, vision, and dental coverage 
Employer paid life insurance and long-term disability 
401k with employer contribution
Pay in Lieu of Benefits option offered
 
Specialists Hospital Shreveport is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.