JOB SUMMARY

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The Insurance Verification Specialist 1, under general supervision, provides patients, physicians and internal hospital personnel with insurance benefit information. This position ensures timely verification of insurance benefits and financial clearance which has a direct impact to the organization's reimbursement from payers for patient accounts that are scheduled and unscheduled.

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SHIFT AND SCHEDULE

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Monday to Friday 8:00 am - 4:30 pm

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ESSENTIAL FUNCTIONS OF THE ROLE

\n\nPerforms financial clearance of patient accounts by verifying insurance eligibility and benefits and ensuring all notifications and authorizations are completed within the required timeframe.\nCompletes appropriate payor forms related to notification and authorization.\nCoordinates the submission of clinical documentation from physicians to payers for authorization needs.\nCalculates accurate patient financial responsibility.\nCommunicates timely with Utilization Review, and collaborates effectively with physician and facility staff to ensure financial clearance of the patient's account prior to scheduled or unscheduled service during the patient's hosptial stay.\nInterprets complex payer coverage information including, but not limited to, network participation status with provider, limited plan coverage and inactive benefits.\nDocuments systems according to the Insurance Verification guidelines to assure accurate and timely reimbursement.\n\n

KEY SUCCESS FACTORS

\n\n1 year of healthcare or customer service experience preferred.\nMust have the ability to consistently meet performance standards of production, accuracy, completeness and quality.\nAbility to know and adhere to payer guidelines by plan and service type.\nRequires good listening and communication skills, and professional telephone etiquette.\nAbility to maintain a professional demeanor in a highly stressful and emotional environment, behavioral health and/or suffering patients in addition to life or death situations.\nMust be able to exhibit a high level of empathy with the ability to effectively communicate with patients and family members during traumatic events, while demonstrating exceptional customer service skills.\nDemonstrates ability to manage multiple, changing priorities in an effective and organized manner.\nExcellent data entry, numeric, typing and computer navigational skills.\nBasic computer skills and Microsoft Office.\n\n

BENEFITS

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Our competitive benefits package includes the following

\n\nImmediate eligibility for health and welfare benefits\n401(k) savings plan with dollar-for-dollar match up to 5%\nTuition Reimbursement\nPTO accrual beginning Day 1\n\n

Note: Benefits may vary based upon position type and/or level

QUALIFICATIONS

\n\n\n\tEDUCATION - H.S. Diploma/GED Equivalent\n\tEXPERIENCE - Less than 1 Year of Experience\n