CALL CENTER REPRESENTATIVE
Jersey Community Hospital (JCH)
Insurance Verification Specialist
Verifies insurance benefits.
Processes accounts to ensure that patients are preregistered & required insurance authorizations and/pre-certifications are obtained prior to the date of service.
Communicates with patients and insurance companies regarding coverage, deposits, and other related matters. Discusses benefits with patients, responds to patient/third party inquiries, and makes referrals. Schedules patient's procedures. Informs patients of pre-op instructions.
Performs scheduling/referral duties according to established procedures.
Prepares patient schedules/documentation for departments.
Completes insurance verification/pre-certification according to payor requirements; identifies outpatient procedures that require pre-certification/second opinion; obtains required information from physician; pre-certifies inpatient admissions.
Requests pre-payments and informs patients of discounts.
Completes Medicare Questionnaire; ensures that medical necessity is established for Medicare/Medicaid patients.
Others roles and responsibilities as assigned.
Skills/Abilities:
- Excellent communication and interpersonal skills required to discuss financial matters with patients and/or their representative, and to work with all levels of professionals at JCH and in other organizations.
- Ability to comprehend large amounts of complex information, and explain complex insurance benefits to patients and/or their representatives.
- Ability to respond to quickly changing priorities and patient needs.
- Demonstrated computer skills and related experience preferred.
Education and Experience:
- High school graduate or equivalency.
Physical Requirements:
- Motor coordination and finger dexterity required to operate computer equipment and other office machines.
- Work is of light demand with routine lifting requirements up to 25 pounds.
Benefits:
- Health Insurance
- Dental Insurance
- Vision Insurance
- Life Insurance
- Retirement
- Paid Time Off
- Tuition Reimbursement
- Health Savings Account
- Wellness Program
- Employee Assistance Program
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