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Insurance Authorization/Verification – Pain Center

Position Type

Full Time, Days, M-F 8am-4:30pm

Overview

Verifies insurance coverage and reviews accuracy of authorizations. Determines patient qualification for coverage. Ensures excellent patient service for patients and families, physicians and staff, and visitors to Clinic. Upholds the mission statement and expectations of the facility.

Key Tasks & Responsibilities

Essential Functions

  1. Verifies current eligibility for patient’s date of service for all insurances to include worker’s compensation, accident insurance and state programs.
  2. Confirms insurance authorization for services by obtaining precertification information from physician’s office, verifies procedure, status and date of service accurately with insurance (on line, etc.) prior to date of service, as applicable.
  3. Documents and scans insurance eligibility and authorization prequalification for all payer’s before date of scheduled admission.
  4. Maintain current listing of facilities current In-Network insurance plans and provide updates to Billers, Registration, Radiology Registration, Scheduling and Physician office staff.
  5. Verifies quarterly and maintains current listing of all insurance plans authorization requirements and provides updates to Billers, Registration, Radiology Registration, and Physician office staff.
  6. Provides exemplary customer service by immediately greeting patient with courteous smile, introducing self and providing a quick, proficient and accurate registration.
  7. Communicates effectively and works cooperatively and professionally with all co-workers, management, patients, visitors, physicians and others. Demonstrates work as a team player.
  8. Greets patients, families, physicians and staff in a courteous manner, and assists as needed.
  9. Documents concisely, precisely and accurately in the system and on records, patient account notes or documents for every patient contact.
  10. Answers incoming phone calls professionally, by identifying facility and/or department and self to caller and directing call to the appropriate destination.
  11. Maintains knowledge of facilities current insurance contracts.
  12. Create and updates Procedure Manuals and Reference Materials to provide process instructions, to ensure accuracy and consistency between users, for facility insurance Authorization/Verification, Registration and Reception positions.
  13. Works closely and partners with referring clinics, learning and understanding their processes and teaching them our facility processes to ensure a smooth patient registration and experience.
  14. Attends all training courses as recommended by Practice Manager.
  15. Abides by all HIPAA policies and requirements.

Non-Essential Functions

  1. Performs other duties as assigned.
  2. Actively supports and upholds the mission and core values of the Hospital.
  3. Remains knowledgeable of and follows the policies of the Hospital.
  4. Maintains patient and hospital confidentiality at all times.
  5. Keeps Manager apprised of day to day situations.

Qualifications & Requirements

High School diploma or equivalent.

Environmental & Physical Requirements

Candidate must be able to read and speak English fluently, have cognitive skills for math, reading, computer skills, and communication skills to deal well with the public as well as peers. Vision for near, mid-range, far and accommodation. Hearing for low, medium and high pitch sounds. Minimal Up and down activity may be possible. Job risks include: Exposure to computer for 6-7 hours per day with typing activities, lifting of 20-30 pounds maximum.

Experience Required

Two years previous experience with insurance authorization and verification required. Computer skills, basic office skills, knowledge of medical terminology required.

Equal Opportunity

KSSH provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or any other protected category as required by state and federal law.

Equal Opportunity Employer

How to Apply

Interested candidates should email their resumes to applicants@ksspine.com.

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