Insurance verification specialist-Ortho Clinic
Job Details
Insurance Verification Specialist
Job Code: IN4528
Full Time Days
8a-5p
ABOUT US
We are welcoming a new era in healthcare where achieving good health is just the beginning. At Company Health Northern VA & Culpeper, we believe in caring for the whole person by getting to know – and making connections with – our patients. By combining the talent and expertise of our people, the breadth of capabilities across our system, and our commitment to helping our communities get better and stay healthy, we are improving the patient experience.
As a Company Health Northern VA & Culpeper team member, you will have a voice in patient care decisions, support the most advanced medical technologies and feel a strong sense of satisfaction from making a difference in people’s lives every day.
JOB TYPE
Classification:Nonexempt
Supervises Positions:No
JOB SUMMARY
Coordinates insurance verification eligibility, pre-registrations, and authorizations for hospital services.
The following is a summary of the major essential functions of the job. The incumbent may perform other duties, both major and minor, that are not mentioned below; and specific functions may change from time to time:
- Following established policies and procedures, verifies eligibility for patients and ensures all pre-authorizations, referrals, and pre-certifications are obtained as necessary by working closely with the physician offices, Utilization Review and Business Office Departments.
- Works closely with the collections department in identifying self-pay patients as well as repeated bad debtors and notifying Financial Counseling.
- Estimates patient financial liability for scheduled services and completes Financial Liability Worksheet as appropriate.
- Works closely with Utilization Review regarding insured patients to identify insurance coverage and limits. Assists uninsured patients pursuing financial assistance options.
- Coordinates appeals denied for no pre-authorization, assisting the patient, physician office and the insurance company.
- Assists Registrars when backlogged with patients in registration as necessary.
- Acts as back up to Schedulers.
- Perform other job-related duties as directed by the Supervisor.
Financial Acumen:Conducts financial analyses.
- Performs computations using advanced mathematical formulas or equations.
- Develops and produces ad hoc financial reports for users throughout the organization.
- Assists with the completion of financial surveys, month-end closing duties, and in the annual budgeting process.
Quality Improvement:Assists in efforts to improve the quality of financial services.
- Applies financial accounting standards to specific transactions/situations/scenarios.
- Evaluates/Assesses/Complies with Internal Controls for financial systems.
- Assists with the coordination of the annual external financial audit.
Collaboration:Works with staff across departments for internal and external financial reporting, accounting, and transactional research.
- Works with study coordinators, regulatory team members, leaders, and finance to reconcile any discrepancies in data entered into the financial systems.
- Prepares financial reports, as directed by leaders and executives.
- Provides financial quality assurance and reporting analysis for metrics across departments.
The incumbent may be asked to perform additional duties as assigned.
QUALIFICATIONS
Education:High School Diploma or GED preferred.
Experience: Minimum of 2 years of related experience in admitting or business office. Refer to the Life Support Training Policy for additional details.
Licensure: N/A
Additional Skills/Requirements Required: Knowledge of basic medical terminology and ability to pass related basic spelling test. Ability to communicate both verbally and in writing. Ability to type 30 words per minute. Background of insurance knowledge is mandatory. Background/knowledge of government/state and patient assistance programs. Working knowledge of ICD-9 and CPT coding. Ability to comprehend insurance cards. Ability to deal directly with the public. Strong computer skills.
Additional Skills/Requirements Preferred: Proficiency in Windows and Microsoft Office preferred.
PHYSICAL DEMANDS
Physical Demand Code:6A, Customer Service
Work Function/Activity: Sedentary to Light Physical Demand
The job requires frequent sitting and standing, occasional walking, and bending/stooping. Frequent repetitive arm, hand, and finger movements. Proficient communicative, auditory, and visual skills. Attention to detail and ability to write legibly. Ability to lift/push/pull up to 20 lbs. occasionally. This job description may not include all assigned duties, responsibilities, or aspects of the job described. It may be amended at any time at the sole discretion of Company Health Northern VA & Culpeper.
OTHER
- May require the use of safety equipment, such as HEPA mask, for infection prevention: Yes
- On call responsibilities as directed: No
- Ability to travel between campus buildings, remote facilities, and out of town as needed: Yes
The University of Virginia, including the Company Health System which represents the Company, Schools of Medicine and Nursing, Company Physician’s Group and the Claude Moore Health Sciences Library, are fundamentally committed to the diversity of our faculty and staff. We believe diversity is excellence expressing itself through every person's perspectives and lived experiences. We are equal opportunity and affirmative action employers. All qualified applicants will receive consideration for employment without regard to age, color, disability, gender identity or expression, marital status, national or ethnic origin, political affiliation, race, religion, sex (including pregnancy), sexual orientation, veteran status, and family medical or genetic information.
Additional Skills/Requirements Required: Knowledge of basic medical terminology. Ability to communicate both verbally and in writing and possess a high degree of excellent customer service skills. Bac...
To perform the functions of contractual allowances reimbursement cost reporting revenue budgeting and special projects. To prepare monthly analyses related to allowances for contractual adjustments an...
This job requires the application and interpretation of policies and procedures and the use of independent judgment in a medical setting. Demonstrates skill in the proficient use of Company software syste...
Additional Skills/Requirements Required: Knowledge of basic medical terminology. Ability to communicate both verbally and in writing and possess a high degree of excellent customer service skills. Bac...
Additional Skills/Requirements Required: Knowledge of basic medical terminology. Ability to communicate both verbally and in writing and possess a high degree of excellent customer service skills. Bac...
Additional Skills/Requirements Required: Knowledge of basic medical terminology. Ability to communicate both verbally and in writing and possess a high degree of excellent customer service skills. Bac...
Additional Skills/Requirements Required: Knowledge of basic medical terminology. Ability to communicate both verbally and in writing and possess a high degree of excellent customer service skills. Bac...
Additional Skills/Requirements Required: Knowledge of basic medical terminology. Ability to communicate both verbally and in writing and possess a high degree of excellent customer service skills. Bac...
Additional Skills/Requirements Required: Knowledge of basic medical terminology. Ability to communicate both verbally and in writing and possess a high degree of excellent customer service skills. Bac...
Patient Care: Provides and documents assistance to patients under the direction and supervision of a licensed nurse. Assists/provides patient care throughout the entire patient experience under the di...
Additional Skills/Requirements Required. Ability to work in a stressful environment. Must be able to work as a “team player” with medical staff, nursing staff, visitors, patients, and other hospital e...
Obtains pre-certification for all inpatient admission and pre-authorization for all outpatient diagnostic tests and performs an administrative support function. This job requires the application and i
Additional Skills/Requirements Required: Knowledge of basic medical terminology. Ability to communicate both verbally and in writing and possess a high degree of excellent customer service skills. Bac...
Requires timely response to vendor and departmental inquiries and concerns regarding invoice actions by interpreting communicating and applying applicable policies and procedures. Reviews and processe...
Sign up and search through 12,050 curated jobs in the Healthcare Edition:
SIGN UP & APPLY
More Interviews
Guaranteed in 30 Days
We guarantee that you will
get more job interviews
in 30 days after using our resume writing services or we will rewrite
your resume for free.