Position Description

OCCUPATIONAL SUMMARY

 

Serves as lead in the performance of insurance verification for patients of Northside and initiating the pre-certification process of patient admissions and outpatient visits.

 

PRIMARY DUTIES AND RESPONSIBILITIES

Contacts insurance companies to determine patient 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 patients. Reviews admission documents/information for accuracy. Demonstrates support for management staff and ensures the department runs efficiently in the Supervisors absence. Monitors department backlogs and assumes additional workload to maintain a zero backlog. Performs reviews of verifier’s work making corrections and assisting in the monitoring and reporting of department quality. Assists in the timely and accurate resolution of referrals from other areas of the Business Office. Assists in the logging and monitoring of referrals to ensure handled to the patient’s benefit. Practices proper safety techniques in accordance with Hospital and Departmental policies and procedures. Immediately reports and mechanical or electrical 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 Associates Degree in Business or related field Ability to work independently. Good oral and written communication skills. Demonstrated knowledge of personal computers and computer spreadsheet programs.

PREFERRED:

Five (5) years prior experience in insurance verification, or related insurance position. Completed medical terminology course.

Service Area Overview