$500 Sign on Bonus Available!

Provides functional oversight to insurance verifiers for the process of verifying insurance coverage for inpatient admissions/outpatient visits. Performs a variety of more complex insurance verifying duties. Maintain operational knowledge of all insurance payers and requirements necessary to ensure maximum and timely reimbursement.Reinforce and actively participate in meeting Hospital Collection Goals. Responsible for participating in the efficient, complete and timely patient registration process that models the customer service philosophy of Community Hospital and Northwest Surgical Hospital.

Essential Functions: 

All Facilities

• Orients new employees, trains employees in new procedures and proved on-going instruction as appropriate.
• Monitors the flow of work for employees doing insurance verification.
• Assists supervisor in assuring that assigned employees are provided with appropriate resources, materials, and methods to complete daily job assignments.
• Receives and assists supervisor with customer complaints and/or concerns.
• Communicate insurance coverage details to patients and inform the patient/guarantor prior to service date regarding payment expectations related to co-payments, co-insurance, and/or deductible amounts.  Establish payment arrangements as appropriate according to established guidelines.
• Provides recommendations to manager or supervisor for the most efficient utilization of assigned personnel. Relays work instruction to Insurance Verifiers from supervisor.
• Provides effective direction, guidance and leadership in the absence of the supervisor.
• Responsible for monitoring and reporting on several processes that may include, but not limited to, identifying and communication status report changes to insurance companies.
• Provides patient and clinical staff with standard information regarding their pre-cert/authorization and insurance eligibility procedures.
• Corresponds with third party carriers and/or patients to obtain insurance data.
• Complies with established departmental policies, procedures, and objectives.
• Demonstrates use of quality improvement in daily operations.
• Consistently demonstrate premier customer service and communication skills with all internal and external customers/contacts and ensure the patient and their family members have the best hospital encounter possible.
• Meet established quality and productivity standards for self and for the team.
• Anticipate and adapt to change (e.g., hospital policy changes, operational/procedures, insurance changes) in a positive manner.
• Foster and reinforce team-based results.
• Adhere to time and attendance standards as outlined in the Human Resource Policy manual.  Provide proper notification of absence or tardiness within established departmental time frames.
• Ensure patient confidentiality adhering to HIPAA guidelines.
• Demonstrate the knowledge, skills and abilities (competencies) to perform the duties outlined above annually in the form of a test or as evidenced by daily quality review and direct observation of the Team Lead and/or the Department Director.
• Track and monitor productivity as requested.
• Keep Department Director apprised of any delays in the registration process.
• Remain current on scheduling, registration, insurance verification, and other patient registration processes in order to cover in the absence of other team members.
• Exhibits typing skills consistent with the demand of the data entry requirements of the position.
• Perform other duties as assigned.

Accountability: 

• Reports to:  Director or Manager, Patient Access
• Supervises: None

Qualifications: 

• High School graduate or equivalent required; 2 years college preferred.
• Experience in patient registration, verification and authorization in a medical center or comparable required.
• Working knowledge of managed care, Medicare, worker’s compensation, indemnity and other third party payers required.
• Working knowledge of governmental regulations and other reimbursement criteria required.
• Possesses the ability to exhibit typing skills consistent with the demand of the data entry requirements of the position, complete forms, and performs simple correspondence.
• Excellent verbal and written communication as well as interpersonal skills required.
• Demonstrated ability to handle multiple tasks with short time-lines, prioritize and organize work, and complete assignments in a timely and accurate manner.
• Exceptional ability to interact and communicate effectively, tactfully, and diplomatically with patients, families, medical staff, co-workers, employers and insurance company representatives.
• Must have a pleasant disposition, positive attitude and possess the ability to maintain a cordial and professional approach during periods of stress. 
• Skill in using office equipment: basic computer skills, photocopier, telephone, fax machine, and calculator.
• Demonstrated ability to think and act decisively in a timely manner.
• Ability to maintain operational knowledge of all insurance requirements necessary to achieve optimal reimbursement. 

Required Physical Demands:    

• Strength (Lift, Carry, Push, Pull): Sedentary; exerting up to 20 pounds of force occasionally
• Standing/Walking:  Occasionally; activity exists up to 1/3 of the time
• Keyboard/Dexterity:  Constantly; activity exists 2/3 or more of the time
• Talking (Must be able to effectively communicate verbally):  Yes
• Seeing:  Yes
• Hearing:  Yes
• Color Acuity:  No

Environmental Conditions:        

• High exposure to hazardous risks including potential for exposure to infections and communicable diseases, blood and body fluids, electrical equipment and chemicals.  Must follow standard precautions.  Heavy work volume and high degree of accuracy required.  Ability to work in a fast-paced environment with frequent interruptions.  May be required to work weekends or flex schedules.   Travel may be required.  Exposed to weather conditions during travel.

What We Offer

As an organization, one way we care for our communities and each other is by providing a comprehensive benefits package that includes:

• Medical, dental, vision, and prescription coverage
• Life and AD&D coverage
• Availability of short- and long-term disability
• Flexible financial benefits including FSAs, HSAs, and Daycare FSA.
• 401(k) and access to retirement planning
• Employee Assistance Program (EAP)
• Paid holidays and vacation