Data Verification Associate

*** Associates degree and one-year relevant work experience required. Five (5) years of relevant work experience (i.e. hospital billing or insurance) may be accepted in lieu of an Associates degree.***

GENERAL SUMMARY:

The Data Verification Associate is responsible for a broad spectrum of duties beginning with the initial receipt of core data elements to include personal demographics, insurance eligibility, insurance verification, and performing a financial review of patient information in order to identify self-pay and uninsured cases. Monitors account reports and work queues for missing or inaccurate information and is responsible for addressing any issues on claim edit work queues to meet timely filing requirements.

PRINCIPAL JOB FUNCTIONS:

1. *Commits to the mission, vision, beliefs and consistently demonstrates our core values.

2. *Serves as work resource and liaison to hospital departments; physician offices, and patients for insurance coverage and hospital account questions.

3. *Adheres to federal regulations regarding Advance Directives, COBRA, Medicare, Corporate Compliance, Joint Commission, OSHA and HIPAA; reports safety and customer concerns.

4. Maintains productivity and quality standards as defined through the organizational and departmental goals and objectives.

5. *Verifies third party insurance coverage from pre-registration, daily admissions and scheduling work queues; updates appropriate computer systems with accurate billing information (to include clean-up of miscellaneous payers/plans).

6. *Confirms demographic and insurance data is complete, accurate, and verified on hospital accounts; identifies patterns of errors and makes recommendations for improvement.

7. *Supports the financial goals of Bryan Medical Center by identifying underinsured, uninsured and self-pay patients for immediate referral to financial counselors or general assistance.

8. *Recovers insurance on patients erroneously listed as "self-pay".

9. *Monitors all registration patient account and claim edit work queues to ensure hospital accounts have accurate billing information listed for timely billing.

10. *Performs "undo billing" when required on accounts in claim edit work queues to correct errors and resubmit the claim.

11. *Identifies Medicaid eligible newborns and updates patient records accordingly.

12. *Performs Patient Registrar work in conjunction with verification assignments as needed.

13. *Identifies educational opportunities for registration staff and works with the Patient Access Educator to develop educational materials.

14. Assists with training and orientation of new staff.

15. Performs other related duties as assigned.

(Essential Job functions are marked with an asterisk "*". Refer to the Job Description Guide for the definition of essential and non-essential job functions.) Attach Addendum for positions with slightly different roles or work-specific differences as needed.

EDUCATION AND EXPERIENCE:

Associates degree and one-year relevant work experience required. Five (5) years of relevant work experience (i.e. hospital billing or insurance) may be accepted in lieu of Associates degree. Knowledge of medical terminology required. Must be 19 years of age to witness legal consents.