Insurance Verification Specialist is responsible for the pre-verification of insurance for patients being admitted into the hospital for care. Ensures insurance coverage by telephone, resolves any issues with coverage and escalates complicated issues to a supervisor or manager. Being an Insurance Verification Specialist interviews patients and completes all paperwork necessary to ensure the admitting process is efficient and all hospital and regulatory policies are in compliance. May require a bachelor's degree in area of specialty. Additionally, Insurance Verification Specialist typically reports to a supervisor or manager. To be an Insurance Verification Specialist typically requires 2 to 4 years of related experience. Gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. (Copyright 2024 Salary.com)
General Statement
Safety & Risk Management (SRM) strives to protect the people, property, and assets of the MSU Bozeman campus. It provides expertise and management in the following areas : Risk assessment and mitigation strategies, MSU Workers’ Compensation (WC) and Stay-at-Work / Return-to-Work (SAW / RTW) programs and policy, Property and Casualty insurance programs and Loss Control, Occupational Health & Safety programs, Industrial Hygiene programs, Chemical and Hazardous Waste programs, Electronic Waste / Universal Waste programs, Biowaste program, Fire & Life Safety, EHS policy and training.
The position of Insurance Specialist reports to the Director of Safety and Risk Management. Duties and Responsibilities
A 4-year loss run of claims is reviewed by multiple levels of management to determine frequency and cause of prior claims, who then put together a written plan to address future mitigation as part of the binder and / or electronic submittal.
This includes what is accomplished for preventive maintenance, self-inspections, impairment testing of fire suppressions systems and equipment, pre-fire planning and cold weather precautions used throughout the year.
WC and SAW / RTW programs, including processing workers’ compensation claims, reporting, participating in claims meetings and associated claims resolution strategies, SAW / RTW opportunities, coordinating job analysis with medical work status restrictions, liaising with the claims administrator for work status, time loss and OSHA reporting requirements, and participating in the Montana University System (MUS) workers’ compensation program retreats and meetings;
ensure all worker’s compensation and risk management reporting is completed in an accurate, compliant, and timely manner for workers’ compensation, property, liability, cyber / information security, vehicles, and annual RMTDD risk exposure reporting, OSHA reporting, and provide claim investigations, documentation and root cause analysis (investigate what led to claim and ensure documentation of evidence).
Required Qualifications Experience, Education, Knowledge & Skills
Preferred Qualifications Experience, Education, Knowledge & Skills
The Successful Candidate Will
Position Special Requirements / Additional Information Must possess a valid driver’s license, an acceptable driving record, and meet all State of Montana requirements to operate State / University vehicles.
If successful candidate possesses a valid out-of-state driver’s license, must obtain a valid Montana driver’s license within 60 days of hire.
Do NOT send a copy of the driver’s license.
This position may work non-routine hours for events and emergencies. This job description should not be construed as an exhaustive statement of duties, responsibilities, or requirements, but a general description of the job.
Nothing contained herein restricts Montana State University’s rights to assign or reassign duties and responsibilities to this job at any time.
The final candidate selected for this position will be required to successfully pass a background check. Physical Demands Approximately 80% of time is spent sitting with some reaching, occasional bending, twisting, and lifting loads not more than 45 lbs.
for up to 50 feet. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily with or without reasonable accommodation.
The requirements listed above are representative of the knowledge, skill, and / or ability required. This position has supervisory duties? Yes
Last updated : 2024-04-23
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