Job Posting for Patient Access Insurance Specialist at Major Hospital · MH PATIENT ACCESS
JOB SUMMARY AND SPECIFICATIONS
JOB SUMMARY
Follows established MHP policies and procedures to verify insurance coverage to ensure necessary procedures and hospitalizations are covered by an individual's provider. The Insurance Verification Authorization Specialist will assure authorization is obtained for all procedures and diagnostic testing to services being rendered. Responsible for communication with insurance carriers and/or providers for purposes of obtaining approval for services requiring authorization, pre-certification, and prior approval for admissions to MHP by using web-based tools, other electronic means where possible, or by telephoning and faxing when necessary. Requires a flexible work schedule that meets the needs of the department. Responsible for answering a high volume of incoming phone calls aas well as making high volume of outbound calls with constant communication to Utilization Review, Social Services, and Surgery Scheduling departments. Requires a flexible work schedule (including evenings, nights and weekends) that meets the needs of the department.
MINIMUM QUALIFICATIONS
Professional & Technical Skills
Minimum 2 years of experience in a hospital or physician practice business office is required. Excellent time management, organizational skills, research/analytical skills, negotiation, written and verbal communication skills and interpersonal skills required. A medical terminology course must be successfully completed prior to employment. Medical prior authorizations or claims experience in managed care setting preferred. Must be effective in a quality-focused, multi-priority environment that frequently deals with stressful situations and important deadlines and schedules. Requires extensive knowledge of medical terminology, private insurance coverage, insurance networks, ICD10, and CPT codes. Basic math skills.
Education
High School Diploma or equivalent. Associate's degree preferred.
License(s) or Certification(s)
CHAA certification highly preferred.
Other Skills or Requirements
Basic office and keyboarding skills (type 40 wpm)and ability to use designated reference materials and office equipment (i.e. computer, printer, fax, calculator, etc.) Requires effective telephone skills. Demonstrates proficient computer skills and multiple databases. Requires complete understanding of time-of-service collections. Specifically, must understand why it is necessary and must be able to effectively communicate this to MHP patient community. Good listening skills required. Requires ability to strictly follow MHP confidentiality guidelines. Ability to use good judgment and maintain one's compuosure in stressful situations.
Skilled to Care for Certain Age-Related Patient Groups (incumbents will be skilled in the care of the following patient groups)
X Does not apply _____ Adolescence (13-17 years) ____ All age groups _____ Infants (0-1 year) _____ Geriatric (65 years) _____ Pediatric/Early Childhood (1-12 years) _____ Adult (18-64 years)
MISSION STATEMENT
Major Health Partners ("MHP") exists to create and deliver superior health care solutions by providing our patients and other customers with optimal clinical and economic outcomes. We will attain these goals by combining the following attributes:
Attracting and retaining professional, adaptable, caring staff dedicated to life long learning using a continuous quality improvement process. Our staff will be measured and rewarded using these same principles.
Combining innovation, existing clinical technologies, disease prevention, and management and information technologies to meet customer needs.
As a public entity, we must make best use of our financial and human resources so we can care for patients without regard for their ability to pay. We must also function as the community’s leader in upgrading the level of health and wellness in the community.
VISION STATEMENT
We will be the best health care resource in central Indiana by recognizing all persons as individuals of value who deserve impeccable facilities and quality service beyond compare.
PILLARS OF EXCELLENCE
We are committed to:
Delivering Quality Clinical Outcomes
Providing a Quality Customer Experience
Recruiting, developing and retaining Quality People
Salary.com Estimation for Patient Access Insurance Specialist in Shelbyville, IN
$32,774 to $40,319
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