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Become An Insurance Verifier

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Working As An Insurance Verifier

  • Interacting With Computers
  • Evaluating Information to Determine Compliance with Standards
  • Communicating with Supervisors, Peers, or Subordinates
  • Documenting/Recording Information
  • Getting Information
  • Mostly Sitting

  • Repetitive

  • $34,430

    Average Salary

What Does An Insurance Verifier Do At Sinai Health System

* Run daily work list assignments from Meditech in an effort to ensure all patients are accurately reflected.
* Cross check this report against the online Meditech work list.
* Effective use of the online eligibility system in use including daily review of Loxogon alerts, these alerts should be corrected as close to real time as possible.
* Responsible for insurance verification, including authorization, benefits, and eligibility on all patients within the assigned work list at least 1 week prior to arrival. (Exceptions will be granted for add on cases, difficult accounts, etc...)
* Ensure an RQI (Radiology Quality Initiative) is secured on specific Blue Cross Blue Shield patients requiring authorization prior to services.
* Collaborates as needed with billing on denied claims and appeals in a timely manner in an effort to resolve discrepancies and expedite payment.
* Collaborates with ancillary departments and referring clinics to ensure correct services are ordered and authorized prior to the service date.
* Efficient use of the charge master within Meditech or any tool in place to determine cost of service and familiarity with contracted survives/insurances

What Does An Insurance Verifier Do At HCA, Hospital Corporation of America

* Contributes to the company by verifying benefits for scheduled patients.
* The Insurance Verifier interacts with the Scheduler to obtain necessary patient information from physician’s offices.
* The Insurance Verifier also determines how much money to collect from the patient up front and what reimbursement is expected from the insurance company.
* DUTIES INCLUDE BUT ARE NOT LIMITED TO:
* Performs insurance pre-certification, verification, interviews patients prior to surgery, and documents information accordingly.
* Verifies all patient eligibility, authorizations, benefits, claim information with insurance companies, and 3rd party payers prior to surgery.
* Determines patient portions due, amounts to be billed, contractual discounts to be taken, or any other authorized discounts that may apply.
* Communicates this information with appropriate personnel for preparation of the pre-admission process.
* Identifies all patient accounts accurately based on what PPO, HMO, or other Managed Care Organizations the patient’s insurance plan might fall under.
* Contacts patients and provides updates on benefit verification information, requests additional information, insurance cards, and explains to the patient his or her financial responsibility such as co-pays, co-insurance, co-deductibles, at time of service.
* Accurately completes data entry necessary including authorizations and benefits as well as patient communication in the appropriate module of AdvantX.
* Makes financial arrangements after consulting with CBO Director/BOM when patient is unable to pay amounts due in full the day of surgery.
* Notifies CBO Director/BOM of any insurance carrier information changes.
* Maintains insurance plan request database; ensuring data is entered accurately and in a timely manner, as determined through facility processes.
* KNOWLEDGE

What Does An Insurance Verifier Do At Ascension Health

* Confirms insurance coverage.
* Determines necessity for pre-authorization and obtains authorization for scheduled procedures.
* Enters patient insurance information into the patient record and documents insurance coverage of services to be provided.
* Determines financial responsibility for services to be provided.
* Notifies patients and/or practitioners of any services requested and/or referred that are not authorized by insurance.
* Communicates with patients and practitioners regarding financial responsibility and insurance coverage issues

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How To Become An Insurance Verifier

A high school diploma or equivalent is typically required for most financial clerk jobs. These workers usually learn their duties through on-the-job training.

Education

Financial clerks typically need a high school diploma or equivalent to enter the occupation. Employers of brokerage clerks may prefer candidates who have taken some college courses in business or economics and, in some cases, require a 2- or 4-year college degree.

Training

Most financial clerks learn how to do their job duties through on-the-job training. Some formal technical training also may be necessary; for example, gaming cage workers may need training in specific gaming regulations and procedures.

Advancement

Financial clerks can advance to related occupations in finance. For example, a loan interviewer or clerk can become a loan officer, and a brokerage clerk can become a securities, commodities, or financial services sales agent, after obtaining the required education and license.

Important Qualities

Communication skills. Financial clerks should have good communication skills so that they can explain policies and procedures to colleagues and customers.

Math skills. The job duties of financial clerks, including calculating charges and checking credit scores, require basic math skills.

Organizational skills. Strong organizational skills are important for financial clerks because they must be able to find files quickly and efficiently.

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Insurance Verifier jobs

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Top Skills for An Insurance Verifier

PatientInsuranceCoverageInsuranceBenefitsMedicaidInsuranceVerificationMedicalClaimsCustomerServiceDataEntryDifferentInsuranceCompaniesMedicalRecordsCPTCodesPatientInsuranceInformationEmergencyInsuranceEligibilityHealthInsuranceCoverageInsurancePoliciesPatientDemographicsMedicalInsurancePhoneCallsInsuranceClaimsInternet

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Top Insurance Verifier Skills

  1. Patient Insurance Coverage
  2. Insurance Benefits
  3. Medicaid
You can check out examples of real life uses of top skills on resumes here:
  • Determined patient insurance coverage and prepared patient insurance quote forms after verification with insurance company contacts.
  • Verify patients' insurance benefits for therapies prior to discharge from the hospital.
  • Print, batch, audit, correct, and generate paper Medicaid claims.
  • Perform pre-registration and insurance verification within 24 hours of receipt of reservation/notification for outpatient services.
  • Facilitated pharmacy and/or major medical claims with insurance companies and MD offices and investigated prior authorizations of any rejections.

Top Insurance Verifier Employers

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Insurance Verifier Videos

Insurance Verifier Role & Responsibilities

Call Center Insurance Example

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