Hoag Health System
INSURANCE VERIFICATION SPECIALIST - PATIENT ACCOUNTING
Hoag Health System, Costa Mesa, California, United States, 92626
Overview
Insurance Verification Specialist - Patient Accounting
at Hoag Health System. The Insurance Verification Specialist verifies insurance and benefit coverage for services in assigned department(s). This role works directly with patients, insurance companies, and clinical departments to verify insurance coverage, obtain proper authorizations, and ensure timely reimbursement of services. Reviews physician orders for medical necessity and accuracy and provides clinical documentation to support proper authorization. Accurately and timely codes insurance in the billing system. Provides patient education of service of benefits, status of pending or denied authorizations and gets assistance in resolving. Determines copayment and deductible amounts, maintains charge entry and reconciles daily charges. Accurately enters insurance benefit and authorization information into patient accounts. Seeks assistance as needed to maintain service levels. May arrange for peer-to-peer evaluations between physician offices and insurance companies as requested. Performs other duties as assigned. Qualifications High school diploma or equivalent required. Two to three years experience in patient access or related healthcare experience required. Intermediate knowledge of Windows computers and data entry required. Experience with billing, insurance verification, coding, authorization guidelines, ICD 10 and CPT-4 coding, and/or medical terminology preferred. Degree and/or certificate in related field preferred.
Additional Department Specific Requirements
Outpatient Treatment Center: Two to three years experience in hospital registration with strong emphasis in Oncology preferred. Radiation Oncology: Two to three years experience in hospital registration with strong emphasis in Oncology preferred.
License Required
N/A License Preferred
N/A Certifications Required
N/A Certifications Preferred
N/A Seniority level
Entry level
Employment type
Full-time
Job function
Other
Industries
Hospitals and Health Care
#J-18808-Ljbffr
Insurance Verification Specialist - Patient Accounting
at Hoag Health System. The Insurance Verification Specialist verifies insurance and benefit coverage for services in assigned department(s). This role works directly with patients, insurance companies, and clinical departments to verify insurance coverage, obtain proper authorizations, and ensure timely reimbursement of services. Reviews physician orders for medical necessity and accuracy and provides clinical documentation to support proper authorization. Accurately and timely codes insurance in the billing system. Provides patient education of service of benefits, status of pending or denied authorizations and gets assistance in resolving. Determines copayment and deductible amounts, maintains charge entry and reconciles daily charges. Accurately enters insurance benefit and authorization information into patient accounts. Seeks assistance as needed to maintain service levels. May arrange for peer-to-peer evaluations between physician offices and insurance companies as requested. Performs other duties as assigned. Qualifications High school diploma or equivalent required. Two to three years experience in patient access or related healthcare experience required. Intermediate knowledge of Windows computers and data entry required. Experience with billing, insurance verification, coding, authorization guidelines, ICD 10 and CPT-4 coding, and/or medical terminology preferred. Degree and/or certificate in related field preferred.
Additional Department Specific Requirements
Outpatient Treatment Center: Two to three years experience in hospital registration with strong emphasis in Oncology preferred. Radiation Oncology: Two to three years experience in hospital registration with strong emphasis in Oncology preferred.
License Required
N/A License Preferred
N/A Certifications Required
N/A Certifications Preferred
N/A Seniority level
Entry level
Employment type
Full-time
Job function
Other
Industries
Hospitals and Health Care
#J-18808-Ljbffr