Insurance Verification Specialist

Insurance Verification Specialist

Everything we do is underscored by a why and that why is one another.

Location: Altru Health System PO Box 6002 Grand Forks, ND 58201 Pay Range: $17.92 - $26.88

Summary:

The Insurance Verification Specialist supports financial clearance through the accurate and timely verification of insurance and benefit information for patients at Altru Health System. The role is also responsible for obtaining and verifying current subscriber information and ensuring referral requirements are secure prior to service resulting in accurate claims and a smooth experience for patients. This position serves as a point of contact for peers in resolving questions or issues related to insurance to improve patient satisfaction and reduce registration and COB denials stemming from front-end activities.

Essential Job Functions:

• Ensures and adheres to strict confidentiality when handling patient charts, records, and registration information.
• Utilizes online systems, phone communication, and other resources to determine eligibility and benefits prior to the date of service.
• Accurately identifies and assigns payer plans in the electronic medical record and notifies appropriate leaders of potential payer or RTE discrepancies in the system.
• Reviews Medicare accounts for completed and accurate Medicare Secondary Payer Questionnaire (MSPQ) to ensure correct filing order for the visit.
• Communicates with patients, clinicians, front-end staff, and translators to obtain any necessary additional or missing insurance or referral information.
• Coordinates benefits by effectively determining primary and secondary liability when needed.
• Alerts physician offices and patients to issues with verifying insurance or meeting referral requirements.
• Holds proficient understanding of insurance terminology.
• Assists in training new insurance verification staff and front-end staff on insurance verification processes.
• Performs other duties as assigned or needed to meet the needs of the department/organization.

Education:

Preferred: Associates - Healthcare

Work Experience:

Required: A minimum of 1 year Related Experience

Language Requirements:

This position requires proficiency in reading, writing, and speaking English to ensure effective communication in the workplace and with patients, families, and team members.

Physical Demands :

Sit: Frequently (34-66%) Stand: Occasionally (5-33%) Walk: Occasionally (5-33%) Stoop/Bend: Occasionally (5-33%) Reach: Frequently (34-66%) Crawl: Not Applicable Squat/Crouch/Kneel: Occasionally (5-33%) Twist: Occasionally (5-33%) Handle/Finger/Feel: Continuously (67-100%) See: Continuously (67-100%) Hear: Continuously (67-100%)

Weight Demands:

Lift -Floor to Waist Level: Sedentary (<10 pounds) Carry: Sedentary (<10 pounds) Push/Pull: Sedentary (<10 pounds) Slide/Transfer: Sedentary (<10 pounds)

Working Conditions:

Indoor: Continuously (67-100%) Outdoor: Not Applicable Extreme Temperature: Not Applicable

Driving Requirement Definitions:

• Professional Drivers: Persons who drive as their main responsibility OR transport passengers or hazardous materials.
• Frequent Drivers: Persons whose main responsibility is not driving, but drive daily or almost daily.
• Occasional Drivers: Persons who drive from once per month to as frequently as once per week.
• Infrequent Drivers: Persons who are generally not expected to drive.

Driving Requirement for this position:

Infrequent Driver

Making a real difference. For one another.

To take the best care of our patients and community including friends, family, and neighbors we need people who are committed to growth, excellence, and one another.

At Altru, you'll find a culture where support and teamwork are at the heart of what we do. You'll have opportunities to advance your skills, work with the latest technologies, experience the fulfillment that comes from giving back, and take your career wherever you want it to go.

Join our team and be a part of a small community with a big heart.

Altru offers a comprehensive benefits package to its full- and part-time employees. Excellent benefits include a health plan and 401(k) retirement plan. Other benefits include a dental plan, vision plan, life and disability insurance, education assistance, paid time off (PTO)