Insurance Verifier

Insurance Verifier

CMMC South Campus - Floresville, TX 78114

Overview

Position Type Pool/PRN Job Shift Day Education Level High School Travel Percentage None Category General Business

Description

Summary Works directly with clinics to identify and secure payer referral requirements for maximum reimbursement

Essential Duties and Responsibilities include the following. Other duties may be assigned.

• Work requests from a queue or email communication from clinic staff or other source
• Confirm validity of any referrals already on file
• Submit request for needed referrals to appropriate authority or PCP
• Follow up to secure authorization prior to patient appointment to ensure reimbursement
• Provide requested clinical information to PCP to support referral
• Advise clinic staff of any anticipated delays for authorization
• Secure referrals and enter them in the patient's electronic record

Education and/or Experience

• Strong, working knowledge of insurance payers to include government, commercial and managed care products
• Ability to establish a good rapport with outside providers and third party payers
• Resourceful, steadfast attitude to make sure that patient needs are met timely
• Comfortable with navigating through the payer websites to secure appropriate benefits and authorization requirements
• Excellent verbal and oral communication skills
• Excellent customer service skills are expected with internal and external customers

Other Qualifications:

• Must be able to multitask and demonstrate excellent organizational skills
• Understanding of insurance contracts and networks essential
• Extensive coding and medical terminology preferred
• Computer literate, knowledge of, or ability to learn multiple clinic/hospital software required.

Connally Memorial Medical Center