The Patient Access Insurance Verification Representative’s primary focus for this role is to mitigate the financial risks to our hospital clients. To do this this position is responsible for contacting patients directly and/or using alternative means to secure patient’s information such as demographics, insurance/coverage and clinical information needed to determine patient’s eligibility, coverage, and insurance limitations.
The Patient Access Insurance Verification Representative will use analytical skills to make decisions and explain coverage details so that patients completely understand what their financial responsibility will be. Associates in this role are empowered to identify additional resources and refer patients who might have difficulty meeting their financial responsibilities. Success in this role is measured with the use of weekly productivity scorecards.
Responsibilities:
Initiates contact with client hospital patients via telephone using appropriate scripting to ensure the required level of benefit and pre-certification/authorization details such as demographics, insurance/ coverage and clinical information are obtained.
Complete appropriate electronic forms with detailed benefit and pre-certification/ authorization information to ensure a clean claim.
Identifies inaccurate plan codes and corrects in the hospital’s main frame.
Work directly with multiple insurance websites to obtain benefits and authorization validation.
Adheres to the guidelines set forth in the Health Insurance Portability and Accountability Act (HIPAA), designed to prevent or detect unauthorized disclosure of Protected Health Information (PHI).
Required Qualifications:
High School diploma or equivalent.
At least one (1) year of similar experience (patient-facing, patient access).
Excellent customer service skills exhibiting good oral and written communication skills.
Ability to type fast and accurately.
Must be able to communicate effectively and professionally to our patients and physician offices.
Desired Qualifications:
Basic Word/Excel
Medical Terminology
Coding/Billing experience
Physical Requirements:
See, read, and/or operate computers, telephones, office equipment, documents, labels, including manipulating paper requiring the ability to move fingers and hands.
Remain sitting, standing, or walking for long periods of time to perform work on a computer, telephone, or other equipment.
Frequent interactions with associates, patient care providers, patients, and visitors that require associate to verbally communicate as well as hear and understand spoken information, alarms, needs, and issues quickly and accurately, particularly during emergency situations.
Manual dexterity of hands and fingers to manipulate complex and delicate equipment with precision and accuracy. This includes frequent computer use and typing for documenting patient care, accessing needed information banding patients, etc.
Need to walk and assist with transporting/ambulating patients and obtaining and distributing supplies and equipment. This includes pushing/pulling gurneys and portable equipment, including heavy items (over 5 lbs.).
The healthcare system is always evolving — and it’s up to us to use our shared expertise to find new solutions that can keep up. On our growing team you’ll find the opportunity to constantly learn, collaborate across groups and explore new paths for your career.
Our associates are given the chance to contribute, think boldly and create meaningful work that makes a difference in the communities we serve around the world. We go beyond expectations in everything we do. Not only does that drive customer success and improve patient care, but that same enthusiasm is applied to giving back to the community and taking care of our team — including offering a competitive benefits package.
R1 RCM Inc. (“the Company”) is dedicated to the fundamentals of equal employment opportunity. The Company’s employment practices , including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person’s age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law. Furthermore, the Company is dedicated to providing a workplace free from harassment based on any of the foregoing protected categories.
If you have a disability and require a reasonable accommodation to complete any part of the job application process, please contact us at 312-496-7709 for assistance.
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To learn more, visit: R1RCM.com
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