Insurance Verification Specialist

Insurance Verification Specialist

Roswell Surgery Center is seeking a strong business partner in the role of an insurance verification specialist Full Time

JOB SUMMARY

 The Insurance Verification Clerk is responsible for validating and entering patient information and insurance coverage into the appropriate computer system. Duties may also include communicating with physician offices, insurance carriers, and patient follow-ups. verify Insurance Benefits and Determine Co-pay based on Insurance Contract.

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES:

•         Review Patient information.
•          Begin chart and pre-admission process. 
•          Verify insurance benefits by reviewing our contract and patient’s quoted benefits.  Determine co-pay.  Post all insurance and billing comments, to include requests by BOM.  Enter all information into patient accounting system….time and date
•          Contact patients regarding money due prior to the date of surgery.
•          Contact patients of their financial responsibility in the timeliest manner that coincides with providing excellent patient experience.
•          Knowledgeable of the Managed Care contract and knowledgeable of the updates

OTHER DUTIES AND RESPONSIBILITIES:

•          As Assigned by Business Office Manager.
•          Participate in USPI EDGE program.
•          Crossed trained to efficiently cover and relieve front desk for lunches and staffing purposes.
•          During downtime assist in Collection Calls, assist in research for the Collection Specialist.
•          Enter all PHI information into system before the end of each Business day.

Qualifications

• High school diploma or equivalent. 
• One to three months of related experience and/or training. 
• Or Equivalent combination of education and experience.
• Communication skills: ability to effectively present information to patients, physicians, and other employees of surgery center. 
• Basic math skills.
• Employed at a doctor’s office or ASC for minimum of 12 months
• Working Knowledge of Managed Care contracts and how they work
• Ability to verbalize the knowledge of Managed Care Contracts
• Working knowledge for manually calculating  insurance allowed amounts and patient responsibility
• Working knowledge and comprehension of EOB’s (Explanation of Benefits)

What We Offer
As an organization, one way we care for our communities and each other is by providing a comprehensive benefits package that includes:

• Medical, dental, vision, and prescription coverage
• Life and AD&D coverage
• Availability of short- and long-term disability
• Flexible financial benefits including FSAs and HSAs
• 401(k) and access to retirement planning
• Paid holidays and vacation

Who We Are
At USPI, we create relationships that create better care. We partner with physicians and healthcare systems to provide first-class ambulatory solutions throughout the United States. We are committed to providing surgical services in the most efficient and clinically excellent manner.

USPI is committed to, and proud of our inclusive culture. An inclusive culture, in our view, is respectful of differences and nurtures and supports the contributions of each individual, while also embracing and leveraging diversity. A diverse workforce, combined with an inclusive culture, makes USPI stronger and better able to meet the needs of our diverse patient and physician population.