Insurance verification representative job description

Insurance Verification Rep

Department: SBS - Patient Access

Purpose: Responsible for interfacing with patient and families to discuss payment options prior to or during hospitalization. Is also responsible for obtaining and documenting patients' insurance coverage and precertification or authorization requirements. Will also assist in reviewing payment alternatives such as Public Aid, SSI, Crime Victims, and Charity. Notifies patients, SBS staff and physicians of uncovered charges and updates data prior to hospitalization for scheduled and non-scheduled admissions. Will assist with collection for co-pay and deductibles. Will ensure all activities achieve high patient satisfaction levels and support successful billing activities, while supporting the standards and philosophies of Genesis Health System. Additional duties may also be assigned. Contacting precertification agencies in a multi-facility admission, pre-registration and emergency service areas.

Report To: Supervisor, Insurance Verification and Pre-Registration

Supervisory Responsibility: No Supervision: The job does not require the provision of guidance or supervision to others. There is no formal responsibility for directing others.

Materials Responsibility: Very Limited. Work requires very limited responsibility for material resources. Examples of resources could include personal work materials, supplies or equipment, or very small amounts of cash. The employee has a very limited or indirect amount of control over these resources. Although human error might require the repair or replacement of materials, usually the cost of correcting these errors is minor. The variety and volume of resources is also very limited. Problems associated with material resources are very uncomplicated.

Key Relationship: Co-workers/Health System Employees, Outside Agencies/Other Health Care Providers, Governing Boards, General Public/Visitors/Volunteers, Physicians/Medical Office Staff, Students/Interns/Residents/Outside Instructors, Patients, Families, and Significant Others, Vendors/Clients, Third Party Payors/Insurance Companies, Local Governments, News Media, Attorneys

POSITION SPECIFICATION

Education: 2 year college program or equivalent experience

Field Of Study: Business, Finance, or related field

Special Training: Experience in billing/AR, insurance verification, customer service, and front desk/registration; quality improvement; word processing and other Windows-based computer applications

Training Preferred: Medical Terminology, CHAT, CPAT

Licensure/Registration:

Experience: More than 1 year experience required.

Interpersonal Skills: Interaction is with a variety of people. These may be fellow employees, customers, the public or others outside the organization. Communications are of limited difficulty. Interactions usually involve short, straightforward exchanges of information. The job requires a limited amount of interpersonal skills. Interactions are non-stressful encounters and dealing with uncomplicated problem situations.

Working Conditions: There are little or no adverse environmental conditions to consider.

Possible Exposure to Blood Borne Pathogens: None

Miscellaneous:

When you are ready to apply, click “Apply Now” and complete your profile. You will then be prompted to complete an online assessment; this assessment takes about 30 minutes to complete. If you are among the qualified candidates, you will receive an invitation within 24 hours to login to our online portal, Vyne, to complete a technology scan and view and apply to the contracts that match your interests. You can view our technology requirements here. You can find more information about our hiring process here.

Overview

Working Solutions' insurance verification contract supports different insurance providers. Contractors working in this program will call back customers after they have submitted an online form to verify their information, assess their needs, and connect them with the right insurance agent. This is a remote independent contractor role.

Schedule:

• Flexible schedule opportunities
• Contractors schedule their hours between 6 am and 11 pm CT Mondays through Fridays, 8 am and 6 pm CT Saturdays, and 9 am and 8 pm CT Sundays.
• Weekday and weekend options

Compensation:

• Earn up to $12 per productive hour (paid $0.24 per minute worked); High performing contractors can earn an equivalent of $14-15 per hour. Contractractors working the Spanish queue will be provided $0.30 per handline minute!
• Contractors are guaranteed a minimum of 37 minutes for each available hour

Required Skills

• Bilingual fluency. Contractors must be fluently bilingual in English and Spanish. Calls will be made to both English speaking and Spanish speaking customers
• Customer service experience and demonstrated ability to deliver high-quality customer service over the phone
• Empathetic with the ability to build rapport with customers while assisting them through the sales process
• Friendly tone and professional demeanor
• Self-motivated and resourceful
• Tech-savvy and avid computer user

Important Information

Technology & Equipment Requirements:

• Personal computer (no tablet)
• Broadband internet connection, recommended at least 10 MBPS
• Wired internet connection (no wi-fi)
• Windows 10 or Windows 11 operating system
• Valid antivirus software installed, running and up to date
• Wired USB headset with microphone

*Full PC requirements

Work Environment Requirements:

• Quiet, uninterrupted space
• Organized desk area

We are currently unable to work with contractors residing in California, New York, Pennsylvania, or Washington. Contractors must also successfully pass a criminal background check.

Contractual Relationship: The relationship between you and Working Solutions is a contractual relationship. You will remain an independent contractor for the duration of this program assignment. Working Solutions will not be responsible for withholding taxes on your earnings while contracted with Working Solutions. When you receive your contract, you will be asked to agree to have no claim against Working Solutions hereunder or otherwise for vacation pay, sick leave, retirement benefits, Social Security, worker's compensation, health or disability benefits, overtime, unemployment insurance benefits or employee benefits of any kind.

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Northern Light Health

Department: Patient Access Management

Position is located: Mercy Fore River

Work Type: Full Time

FTE: 1.0 (40 hours)

Work Schedule: 8:00 AM to 4:30 PM

Summary:

Performs insurance verification duties to financial clear the patient in advance of service date. Verifies healthcare coverage and benefits for applicable services, working with the patient, provider, and payer to ensure accurate information and needs are met in advance of service.

Responsibilities:

• Ensures excellent customer service when assisting patients, providers, and other departments • Collects and updates patient demographic and insurance information, making changes as necessary to ensure accuracy. Handles more complex cases and assists with additional needs pertaining to insurance benefits, referrals or authorizations • Verifies precertification/authorizations for scheduled services utilizing internet sites, payer contacts, and software as appropriate. Assesses coverage and benefits, and accurately determines patient responsibility. • Identifies self pay patients and shares estimate information with financial counseling for assistance with patient financial obligation and options. • Partners closely with the clinical, office, billing, and registration teams and works the authorizations and referrals timely, as applicable • Appropriately documents all conversations with insurance companies and health care facilities that pertain to the payment of services. • Refers patients and/or staff with issues or concerns to supervisor. • Maintains and exhibits a current knowledge of insurance plans, associated workflows and information, and the impact of this role within the revenue cycle. • Strives to maximize revenue and minimize bad debt. • Maintains a safe environment complying with NLH policies and procedures; reports and directly addresses environmental hazards and violations of patient safety policy and/or protocol when involved or observed. • May perform other duties upon request.

Competencies and skills:

Essential:

* Achieves Results: Sets high standards for their own outcomes and seizes opportunities to engage others towards objectives. Consistently moves forward with direct actions in order to attain or exceed objectives. Manages their own time effectively to accomplish assigned tasks. Successfully prioritizes multiple projects and duties as needed.

* Behaves with Integrity and Builds Trust: Acts consistently in line with the core values, commitments and rules of conduct. Leads by example and tells the truth. Does what they say they will, when and how they say they will, or communicates an alternate plan.

* Cultivates Respect: Treats others fairly, embraces and values differences, and contributes to a culture of diversity, inclusion, empowerment and cooperation.

* Demonstrates Adaptability: Learns quickly when facing a new problem or unfamiliar task; is flexible in their approach with changing priorities and ambiguity. Manages change effectively and does not give up during adversity. Capable of changing one's behavioral style and/or views in order to attain a goal. Absorbs new information readily and puts it into practice effectively.

* Effectively Communicates: Listens, speaks and writes appropriately, using clear language. Communication methods are fitting to the message(s), audience, and situation and follow-ups are regular and timely. Shows that important (non-) verbal information is absorbed and understood and asks further questions to clarify when necessary. Expresses ideas and views clearly to others and has ability to adjust use of language to the audiences' level.

* Fosters Accountability: Creates and participates in a work environment where people hold themselves and others accountable for processes, results and behaviors. Takes appropriate ownership not only of successes but also mistakes and works to correct them in a timely manner. Demonstrates understanding that we all work as a team and the quality and timeliness of work impacts everyone involved.

* No previous experience required.

* Practices Compassion: Exhibits genuine care for people and is available and ready to help; displays a deep awareness of and strong willingness to relieve the suffering of others.

* Seeks Process Improvement & Applies System Thinking: Possesses and gains insight into situations, problems and processes. Understands the interconnection between organizational elements. Deconstructs problems and systematically investigates the various components. Considers the impact of actions on the entire process/system. Detects problems and opportunities, recognizes important information, and links various data to trace potential causes and relevant details.

Education:

Essential:

* High School Diploma/General Educational Development (GED)

Working conditions:

Essential:

* Potential exposure to abusive and/or aggressive people.

* Work with computers, typing, reading or writing.

* Lifting, moving and loading 20 to 30 pounds.

* Potential exposure to noise levels being uncomfortable.

* Prolonged periods of sitting.

* Potential exposure to noxious odors.

* Potential exposure to very hot or cold temperatures.