Insurance Verifier

Insurance Verifier

North Central Surgical Center is a highly successful, Baylor Scott & White affiliated hospital located in Dallas, TX. We partner with the very best team members and medical staff in the area. We are a surgical focused hospital that performs over 12,000 procedures per year.

North Central Surgical Center is currently seeking a Full-Time Insurance Verifier in our Business Office Department.

• Retrieves patient information, verifying patient information is accurate (spelling of name, D.O.B., gender, etc.).
• Verifies patient insurance benefits by utilizing online websites or by contacting the carriers directly.
• Obtain authorizations from insurance companies/physician offices, pre-certification, requirements and referrals as needed.
• Ensure high cost implant/supply or equipment rental is included on authorization.
• Check insurance company approved procedure lists/medical policies.
• Calculates patient deductibles and/or copays based on contract interpretation of Managed Care Contracts and enter into the patient accounting system and spreadsheets provided.
• Contact patients regarding moneys due prior to date of surgery.
• Determine patient responsibility for payment based on contract and account reviews.
• Determine patient responsibility for cash payment based on reimbursement and account reviews.
• Fill out verifications sheet and upload to patient charts
• Assist front end staff in understanding verification of eligibility and/or patient responsibility.
• Answer incoming department call and assist patients with their benefit inquires & quotes
• Performs miscellaneous job-related duties as assigned.

Requirements:

• Minimum two years' experience in insurance verification & pre-certification for surgeries and medical terminology preferred.
• Strong knowledge of Government and State Medical plans.
• Strong Knowledge of Managed Care Contract.
• Communication skills: ability to effectively present information to patients, physicians, and other employees of surgery center.
• Proficient in computers and relevant software applications
• Basic math skills
• Provide exceptional customer service
• Cerner experience preferred.