What are the responsibilities and job description for the INSURANCE VERIFIER position at Dameron Hospital?
Dameron Hospital is a fully accredited, non-profit, 200 bed community hospital providing acute and tertiary level care to San Joaquin County residents. Now managed by Adventist Health, our hospital remains committed to providing the high quality care that has earned various state and national recognitions, as well as numerous awards and accolades. The hospital has also been designated by Blue Shield of California as a Blue Distinction® Center for Bariatric Surgery and for Knee and Hip Replacements as part of the Blue Distinction® Centers for Specialty Care program. In addition to being a top-rated joint replacement center in the Stockton area, and the county's leading orthopedic hospital, Dameron has also been recognized as a Top Performer for its Quality Metrics by The Joint Commission.
POSITION SUMMARY:
Responsibilities includes but not limited to: Ensures compliance with applicable billing policies and procedures relating to Medicare and/or Medi-Cal payer contracts, agreements and requirements. Demonstrates and maintains a thorough knowledge and understanding of how to determine primary, secondary, or tertiary insurance coverage. Reviews patient accounts by monitoring real time admission reports and prioritizing to ensure timely notifications to avoid reimbursement and front end denials. Determines appropriate billing distributions and processes statements. Monitors outstanding accounts in a timely manner. Regularly monitors reports to ensure timely follow-up. Receives and answers insurance and authorization related inquiries. Must be able to perform jobs in all patient care and operational areas subject to reasonable accommodations, also be able to employ all mandatory safety devices and procedures. This is a union position.
Requirements:
POSITION QUALIFICATIONS:
Education:
High School Diploma or equivalent.
Must be proficient in the English language.
Must possess operational knowledge of Windows, Microsoft Word and other office machines.
Experience:
Minimum of one year hospital billing or insurance verification with Medicare, Medi-Cal and commercial
insurance experience required.
Minimum of one year Patient Registration experience required.
Licenses/Certificates:
None
Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations, including, but not limited to, measles, mumps, flu (based on the seasonal availability of the flu vaccine typically during October-March each year), COVID-19 vaccine (required in CA and HI) or the option of COVID-19 vaccine or weekly testing (required in OR), etc., as a condition of employment, and annually thereafter. Medical and religious exemptions may apply.
