Hospital Insurance Verifier: Timely Accurate Reimbursements

AHMC Healthcare Inc.; Anaheim (CA); Presencial; USD 42.000 - 58.000; Jornada completa

Descripción de la vacante

AHMC Anaheim Regional Medical Center is seeking an Insurance Verifier to ensure timely and accurate verification of patient insurance benefits, eligibility, and required authorizations. The role supports revenue cycle and interacts with case management, patient services and hospital staff to secure prompt reimbursement.

The candidate will apply knowledge of HMO/PPO/POS/EPO contracts and government payors while maintaining compliance and patient confidentiality.

Formación

• Experience applying infection control policies.
• Knowledge of hospital payors (HMO, PPO, POS, EPO) and government payors.
• Proficient in verifying insurance coverage and eligibility.
• Ability to obtain authorizations and tracking numbers.
• Ability to collaborate with case management and patient services to improve reimbursement.

Responsabilidades

• Provides timely and accurate insurance verification, obtains eligibility, benefit coverage, authorization and tracking numbers.
• Verifies coverage for inpatients, outpatients and direct admissions in a timely manner.
• Obtains authorization, pre-certification and tracking numbers on all patient types.
• Reports registrations to the appropriate pre-certification Review Company and medical group/ IPA, as required.
• Participates in department performance improvement projects and supports ongoing process improvement.
• Maintains effective working relations with coworkers, case management, nurses, physicians and hospital staff.

Conocimientos

Infection control

Standard precautions

Insurance verification

Payor contracts interpretation

Patient financial responsibilities

Per diem/case rate interpretation

Herramientas

Registration system

Financial system

Descripción del empleo

AHMC Anaheim Regional Medical Center is seeking an Insurance Verifier to ensure timely and accurate verification of patient insurance benefits, eligibility, and required authorizations. The role supports revenue cycle and interacts with case management, patient services and hospital staff to secure prompt reimbursement.

The candidate will apply knowledge of HMO/PPO/POS/EPO contracts and government payors while maintaining compliance and patient confidentiality.