Insurance Verification Rep

FT Monday-Friday 8:30-5p

Summary

The Insurance Verification Representative is responsible for obtaining authorizations for all required exams and document approvals. The person in this position is responsible for obtaining information on the patient's eligibility status with the insurance companies to ensure proper coverage and payment for services. The person in this position works closely with insurance providers and referring physicians' staff to obtain necessary patient history and notes in order to expedite processing.

Essential Duties and Responsibilities

• Ensures accurate, timely, and thorough documentation and completion of all necessary paperwork, according to established standards.
• Ensures accurate and timely data entry into the RIS system for each patient, according to established standards.
• Utilizes telephone voice response systems and website solutions to obtain information on patients' eligibility status with insurance companies.
• Works with patients to obtain complete and correct insurance information, discusses eligibility results and alternative payment methods.
• Properly analyzes various payor eligibility responses to find the information needed to complete verifications.
• Obtains and confirms insurance pre-authorizations when necessary.
• Follows all HIPAA, compliance, privacy and confidentiality standards.
• Maintains patient confidentiality at all times.
• Demonstrates professionalism and courtesy to patients, families/guests and other team members.
• Communicates clearly and effectively.
• Communicates with vendors, patients, referring physicians, co-workers and all team members in a courteous and professional manner.
• Provides thorough and accurate information to all callers.
• Maintains self-control when dealing with difficult patients and/or situations. Involves manager or team leader when necessary.
• Maintains insurance verification log of accounts/procedures verified.
• Contacts insurance providers via email or phone to review status of authorizations.
• Works closely with referring physicians' staff to obtain patient notes and begin process of authorizations.
• Scans all completed paperwork into eRad RIS.
• Completes all paperwork in a timely and accurate manner.
• Promotes a positive and supportive relationship with referring community and fellow employees.
• Performs other duties as assigned.

Minimum Qualifications, Education and Experience

• Must have one of the following: a high school diploma or general education degree (GED), one to three months of related experience and/or training, or an equivalent combination of education and experience.
• Possesses and utilizes excellent customer service skills, strong public relations skills, and exceptional written and verbal communications skills.
• Must be detail-oriented and organized, possess clerical skills, and have the ability to interact effectively with doctors, referring doctors and staff, patients, vendors, peers, and management.

Quality Standards

• Communicates, cooperates, and consistently functions professionally and harmoniously with all levels of supervision, co-workers, patients, visitors, and vendors.
• Demonstrates initiative, personal awareness, professionalism and integrity, and exercises confidentiality in all areas of performance.
• Attends regular corporate meetings as requested.
• Follows OSHA regulations, RadNet and site protocols, policies and procedures.
• Follows HIPAA, compliance, privacy, safety and confidentiality standards at all times.
• Practices universal safety precautions.
• Promotes good public relations on the phone and in person.
• Adapts and is willing to learn new tasks, methods, and systems.
• Reports to work regularly as scheduled; consistently punctual with respect to working hours and lunch schedules, and maintains satisfactory personal attendance in accordance with RadNet guidelines.
• Completes job responsibilities in a quality and timely manner.

Physical Demands

This position often requires sitting, standing, walking, bending, twisting reaching with hands and arms, using hands and fingers, handling, constant talking, and hearing. Also, must be able to lift over 50 pounds, occasionally. All employees are to assist and participate as members of a lift assistance team (for special accommodation patients or any patient requiring assistance onto a table or equipment placement) to initiate or complete an exam or procedure.

Working Environment

Representatives work in a medical office setting with low to moderate noise level.