Insurance Verification Clerk’s primary responsibilities are:
1) to gather all pertinent patient information on scheduled patients; 2) to accurately pre-admit patients; 3) to pre certify all applicable admissions/pre-admissions;
4) to obtain signatures on all appropriate admissions forms if appropriate; 5) to ensure that patient benefits and eligibility are verified and the details of such are entered into the patient accounting system for all patients touched; 6) an estimate of charges will be provided to all scheduled patients and collection of all co pay’s/deductible’s that are owed to the hospital to meet departmental requirements; 7) identify and refer patients to the financial assistance department at hospital; and 8) to provide a full range of insurance verification functions on an as needed basis as requested by Management.
Additionally, all job duties will be completed in a manner that is consistent with the highest quality of guest relations which results in a positive experience for the patient and/or their family member(s).The position also requires accountability for admitting/registering and/or providing verbal directions to patients and/or family members in any or all the following age groups: neonatal, pediatric, adolescent, and/or geriatric demonstrating the appropriate skills to understand and react effectively to the needs of these patients and/or family members.

SHIFT AND SCHEDULE

Monday - Friday 8:00 AM - 5:00 PM

ESSENTIAL FUNCTIONS/PERFORMANCE EXPECTATIONS

• Ability to accurately complete data entry tasks for new and established MMH patients including all required paperwork (i.e. consent forms, ABN, MSP forms, etc.)
• Ability to interpret payer contracts, understanding different types of reimbursement methodology and accurately figure and communicate patient estimated out of pocket expenses to patients and guarantors.
• Ability to accurately complete insurance verification, authorization and pre-certification requirements of each different payer source and apply those benefits to determine a patient’s estimated out-of-pocket expense.
• Ability to provide accurate financial counseling information to patient or guarantor and makes the appropriate referrals to the eligibility office when necessary following hospital policies and procedures in patient balance collections.
• Ability to document all patient/guarantor interactions into the patient accounting systems

EDUCATION AND EXPERIENCE

• Must be a high school graduate or equivalent.
• 1 year office experience preferred
• Basic math skills are required
• Excellent customer service and communication skills.
• Must be able to use Microsoft Excel, Office and Outlook

PHYSICAL REQUIREMENTS
To perform this job successfully, an individual must be able to perform each essential responsibility satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The individual must be able to:

• Stand, walk, sit, stoop, reach, lift, see, speak and hear. Lifting is limited to 35 lbs. for clinical staff and to 50 lbs. for non-clinical staff. The individual must use an assisted-lift device or get another individual(s) to assist with the lift that is over these maximum limits