Patient Access Rep

Insurance Verifier

Has in-depth knowledge in all the functions of the Admitting Department. Must have excellent communication skills, including the ability to speak, read and write English proficiently. Must be comfortable with computers and medical terminology. In-depth knowledge of all insurance types, including government health programs.

Responsibilities include:

• Obtaining insurance information/verification/authorization to ensure financial clearance of patient accounts.
• Completing all registration and insurance fields in both professional and/or hospital registration information systems.
• Completing Medical Necessity on all Medicare accounts as required.
• Calling insurance or using Internet portals to obtain and document insurance eligibility and benefits, financial responsibility, authorization, pre cert's as required, and contacting medical groups/IPA's as needed.
• Calculating patient liability on hospital accounts.
• Ensuring all insurance plans are properly selected in all registration and scheduling information systems.
• Clearing assigned worklists in any of the information systems.
• Communicating with physician offices regarding proposed admissions, special procedures, outpatient referrals and same day surgeries.
• Preparing pre-registration on scheduled procedures such as ancillary, diagnostic, surgeries.
• Contacting patients and/or MD office as needed for additional information.
• Utilizing fax applications as appropriate.
• Performing document imaging as required.
• Assisting Supervisor as needed with special projects and other duties assigned.

Medical Enterprise - Non-Clinical Onboarding - Must complete all onboarding requirements prior to the start date, with no exceptions.