Fresno Surgical Hospital is an extraordinary hospital created entirely to deliver excellence and quality in surgical care to each patient. Our unique facility and staff provide a hospitality- inspired, healing environment unlike anything experience in a traditional hospital. Our commitment to innovation, shared values and excellence can be reflected in exceptional satisfaction scores from patients, physicians and staff.

Utilizing the telephone and appropriate Internet applications, the Insurance Verifier is responsible for verifying benefits and eligibility for all insurances subscribed to by patient. Using independent judgment, this individual protects the facility by way of their knowledge of Fresno Surgical Hospitals contracted and non-contracted payors. Acts as liaison with patients, physician offices and internal departments.

Salary: $24.00

Hours: Monday - Friday 8 hours, non-exempt

Minimum Education and Experience:

• High School Diploma or equivalent
• Previous billing experience preferred.  

Required License and Certification

• N/A

Required Skills

• Must be familiar with healthcare industry concepts, practices, and procedures.
• Thorough understanding of different insurance plans, government agencies, Medicare and Medicaid.
• Ability to maintain collaborative working relationships to ensure a positive and productive work environment.
• Ability to provide exceptional customer service.
• Basic computer knowledge.
• Correct and safe operation of office equipment, i.e., copy machine, adding machine, fax.
• PC competency, working knowledge of Microsoft Office Products (Word/Excel)

Essential Functions

• Billing Information/Procedures:
• Consults with internal and external entities to obtain and/or verify billing information.
• Ensures accounts are financially secure by review of benefits, authorization/pre-certification requirements, and estimated patient responsibility.
• Establishes acceptable payment arrangements in accordance with Fresno Surgical Hospital policy.
• Analyzes statements and letters to ensure patient billing accuracy prior to mailing.
• Keeps abreast with insurance contracts to include billing procedures and rates.   
• Insurance Benefits/Procedures:
• Verifies insurance benefits and eligibility utilizing the Patients Scheduled by Surgery date report for assigned patient alpha; cases are verified a minimum of six (6) days prior to the procedure.
• Monitors and addresses procedure add-on and cancellation e-mails.
• Accurately updates Patient demographic information and ensures documentation standards are followed.   
• Professional Interaction/Patients:
• Acts as primary contact for internal and external entities assisting with insurance questions, i.e., benefits, covered vs. non-covered services, self-pay and patient estimation quotes based on out of pocket, deductible, coinsurance, etc.
• Contacts patients and clearly relays benefit, eligibility and approximate patient responsibility when estimation is $250.00 or greater.
• Promptly returns calls for messages received.
• Admission/Receipts/Scheduling Documents:
• Picks up the Admission and Scheduling department documents daily; reviews documents for updates, files and/or distributes documents as appropriate.
• Provides Admitting department with receipts and/or consent forms (when appropriate) no later than 3:00pm for succeeding day scheduled cases.    
• Multitasks/Duties:
• Other duties as assigned.

Fresno Surgical Hospital complies with federal, state, and/or local laws regarding mandatory vaccination of its workforce.  If you are offered this position and must be vaccinated under any applicable law, you will be required to show proof of full vaccination or obtain an approval of a religious or medical exemption prior to your start date.