MedStar Health
Insurance Verification Specialist (M-F 4:45am-1:30pm)
MedStar Health, Washington, District of Columbia, us, 20022
Overview
Insurance Verification Specialist (M-F 4:45am-1:30pm)
MedStar Health
role in the Surgery Center. Department: Surgery Center Status: Full-time, 40-hours per week Schedule: Monday-Friday, 4:45am-1:30pm This position has a hiring range of $18.33 - $31.61. Responsibilities Responsible for inpatient and outpatient registration activities, which include assessing the patient's financial status, identifying and obtaining a source of payment and gathering sufficient information to facilitate reimbursement, ensuring the notification is accurate and complete, and interfacing with insurers and members of the health care team. Requires proficient and professional encounters with other departments, insurance companies, third-party administrators, physician offices, and associates to input correct patient demographics and insurance information, verify eligibility, and identify and obtain referral and authorization needs to ensure a seamless revenue cycle process. Initiates and maintains referral and preauthorization records for all patients and ensures that authorizations are obtained, updated, and recorded in a timely manner to minimize delays and denials. Provides complete pre-authorization, insurance verification, and basic benefits information on all outpatient registration accounts using the Medical Center's clinical systems (e.g., GE Centricity Business/IDX and supporting eligibility software) to ensure accurate registration and capture of authorization/referral information for IDX and SMS Invision; updates patient demographics and insurance information; maintains department standards for accounts accessed and accuracy rates. Ensures presence of pre-authorization and/or insurance referral numbers prior to services, assists with tracking continuing or multi-use authorizations and referrals, and coordinates with clinical staff if difficulties arise. Provides benefit coordination to determine whether services are covered, and whether co-pays or deductibles are due at point of service; refers some cases to Financial Assistance assessment prior to treatment. Corrects accounts with erroneous registration information and ensures that all associated claims have correct financial classification to support timely and accurate claim submission and revenue cycle processes. Communicates effectively with patients and other stakeholders to clarify information and follow up as needed; maintains positive relationships with external audiences. Acts promptly on system edits to ensure proper actions on accounts for reimbursement (IDX Alerts and SMS). Documents accurate information in the Patient Accounting system used by staff including PUBS, PFS, CBO, Case Management, and Utilization Review (UR). Collaborates with clinical departments, UR, and other business units to ensure reimbursement criteria are met; serves as a resource for registration, FSC/Plan assignment, and referrals. Escalates system or procedural problems to PUBS and PFS leadership to improve processes and participates in educational and professional development activities. Performs other duties as appropriate to the position; the responsibilities listed are general and not all-inclusive.
Qualifications Education
High School Diploma or GED required Associate's degree preferred Consideration will be given to an appropriate combination of education/training and experience
Experience
Experience in a customer service-oriented environment required Experience in hospital or physician registration, insurance verification and/or medical billing required
Licenses and Certifications
N/A
Knowledge, Skills, And Abilities
Excellent oral and written communication skills, excellent customer service skills, detail oriented, and excellent organizational skills. Proficiency with medical terminology, and experience with basic anatomy/physiology. Understanding of medical terminology, ICD-9 codes, and third-party payer procedures. Knowledge of computerized registration, scheduling, and billing systems is a plus. Good interpersonal and communication skills.
#J-18808-Ljbffr
Insurance Verification Specialist (M-F 4:45am-1:30pm)
MedStar Health
role in the Surgery Center. Department: Surgery Center Status: Full-time, 40-hours per week Schedule: Monday-Friday, 4:45am-1:30pm This position has a hiring range of $18.33 - $31.61. Responsibilities Responsible for inpatient and outpatient registration activities, which include assessing the patient's financial status, identifying and obtaining a source of payment and gathering sufficient information to facilitate reimbursement, ensuring the notification is accurate and complete, and interfacing with insurers and members of the health care team. Requires proficient and professional encounters with other departments, insurance companies, third-party administrators, physician offices, and associates to input correct patient demographics and insurance information, verify eligibility, and identify and obtain referral and authorization needs to ensure a seamless revenue cycle process. Initiates and maintains referral and preauthorization records for all patients and ensures that authorizations are obtained, updated, and recorded in a timely manner to minimize delays and denials. Provides complete pre-authorization, insurance verification, and basic benefits information on all outpatient registration accounts using the Medical Center's clinical systems (e.g., GE Centricity Business/IDX and supporting eligibility software) to ensure accurate registration and capture of authorization/referral information for IDX and SMS Invision; updates patient demographics and insurance information; maintains department standards for accounts accessed and accuracy rates. Ensures presence of pre-authorization and/or insurance referral numbers prior to services, assists with tracking continuing or multi-use authorizations and referrals, and coordinates with clinical staff if difficulties arise. Provides benefit coordination to determine whether services are covered, and whether co-pays or deductibles are due at point of service; refers some cases to Financial Assistance assessment prior to treatment. Corrects accounts with erroneous registration information and ensures that all associated claims have correct financial classification to support timely and accurate claim submission and revenue cycle processes. Communicates effectively with patients and other stakeholders to clarify information and follow up as needed; maintains positive relationships with external audiences. Acts promptly on system edits to ensure proper actions on accounts for reimbursement (IDX Alerts and SMS). Documents accurate information in the Patient Accounting system used by staff including PUBS, PFS, CBO, Case Management, and Utilization Review (UR). Collaborates with clinical departments, UR, and other business units to ensure reimbursement criteria are met; serves as a resource for registration, FSC/Plan assignment, and referrals. Escalates system or procedural problems to PUBS and PFS leadership to improve processes and participates in educational and professional development activities. Performs other duties as appropriate to the position; the responsibilities listed are general and not all-inclusive.
Qualifications Education
High School Diploma or GED required Associate's degree preferred Consideration will be given to an appropriate combination of education/training and experience
Experience
Experience in a customer service-oriented environment required Experience in hospital or physician registration, insurance verification and/or medical billing required
Licenses and Certifications
N/A
Knowledge, Skills, And Abilities
Excellent oral and written communication skills, excellent customer service skills, detail oriented, and excellent organizational skills. Proficiency with medical terminology, and experience with basic anatomy/physiology. Understanding of medical terminology, ICD-9 codes, and third-party payer procedures. Knowledge of computerized registration, scheduling, and billing systems is a plus. Good interpersonal and communication skills.
#J-18808-Ljbffr