Position Description

OCCUPATIONAL SUMMARY

 

Verifies insurance and initiates the pre‑certification process of patient’s admission.

 

PRIMARY DUTIES AND RESPONSIBILITIES

Contacts insurance companies to determine patient’s eligibility and coverage for hospital admission. Contacts pre‑certification companies to initiate pre‑certification and obtain approval of confinement. Works closely with the Financial Counselors in evaluating patient’s insurance coverage. Documents appropriate information regarding benefits to be received by the hospital, and the subsequent financial responsibility of the clients. Reviews admission documents/information to ensure accuracy. Demonstrates support for management staff. Monitors department backlog and assumes additional workload to maintain a zero backlog. Practices proper safety techniques in accordance with hospital and departmental policies and procedures. Immediately reports any mechanical or electrical equipment malfunctions, unsafe conditions, or employee/patient/visitor injury‑accident to Manager.

Position Requirements

REQUIRED:

Two (2) years experience in insurance verification, pre- certification, billing, OR related insurance position or equivalent education, computer skills and effective communication skills. Ability to work independently. Good communication skills, and basic typing ability.

PREFERRED:

Three (3) years prior experience in insurance verification, or related insurance position. Two (2) years of college with an emphasis in Business. Completed medical terminology course.

Service Area Overview