Lead Insurance Verifier

Job Details:

Job Summary:

The Lead Insurance Verifier is responsible to assist with the supervision of the financial clearance team ensuring patients receiving services at our organization are financially cleared. This individual is responsible for obtaining timely and accurate authorizations for all hospital services where needed and to ensure that patents are contacted timely in regard to their financial responsibility (when applicable). The Lead Insurance Verifier will be responsible to perform other tasks as needed as assigned by Patient Access leadership.

Responsibilities:

• This position is responsible for the day to day operations of the MHRH verification department that verifies various types of insurance benefits from simple office visits to very complex surgical and medical procedures, securing authorization, notification for Inpatient and Outpatient surgery, diagnostic testing and Inpatient admissions for account information for reimbursement

• Prepares written estimates per patient. Calculates estimated patient responsibility based on scheduled procedures and insurance allowable per managed care grid

• This position ensures coordination and communication between departments becoming a resource for the patient, physician, and facility. Communicates with Doctor’s office staff any issues with patients such as difficulty reaching the patient or inability to make an acceptable Financial Arrangement

• This position is also responsible for ensuring patient satisfaction as it relates to securing accounts prior to the patient’s arrival to the medical centers

• It is essential that this information be documented timely and accurately
• Reviews eligibility discrepancies

• Ensure Admission Notification has been completed and verify insurance eligibility
• Ensure Motor Vehicle Accident, Workers Compensation or other Third Party Liability paperwork has been completed

• Maintain current knowledge of and competency with numerous Federal, State and other regulatory body compliance regulations and third-party insurance plans
• Must be able to follow directions and to perform work according to department standards when no directions are given
• Review reporting to identify missed authorizations which will be provided to the appropriate verifier or obtain the authorization/referral to ensure that it is obtained
• Basic knowledge of patient accounting and insurance systems
• Accountable for maintaining a close working relationship with team mates, point of service registrars, departmental staff, physician’s offices
• Communicates with all customers (patients, families, staff, physicians, vendors, etc) in a helpful and courteous manner while extending exemplary customer service

Experience:

A minimum of one year of experience in a of patient access/insurance verification experience preferred.

Education:

High school graduate or equivalent Licenses / Certifications. None

Other:

Knowledge of HDX, Cerner Millenium, Invision preferred. Must possessexcellent communication skills and the ability to conduct themselves in a professional manner at all times.Must have good problem solving skills and the ability to know when to seek assistance to ensure positive customer relations

About Us:

NorthEast Provider Solutions Inc.