Insurance & Care Coordination Specialist

Ventura Services Florida; Sunset Corners (FL); On-site; USD 28,000 - 40,000; Full time

Job summary

Ventura Services Florida is seeking an admissions verifier to verify and monitor patient insurance benefits, authorizations, and entry of information into the computer system. The role includes communicating with physicians, scheduling, and ensuring accuracy of patient data in a fast-paced hospital setting.

The ideal candidate has an Associate Degree, hospital admission or customer relation experience, and preferably bilingual English/Spanish.

Qualifications

• Associate degree minimum.
• Experience in hospital admission or customer relation.
• On-the-job training or equivalent training in admitting process.
• Be familiar with medical terminology.
• Be proficient in using a typewriter and computer for data processing.
• Minimum 1 year experience in hospital or mental health setting.
• Bilingual (English/Spanish) desired.

Responsibilities

• Verifies and obtains all authorizations and necessary pre-certifications from insurance companies.
• Informs Supervisor about patients who are underinsured or without insurance
• Perform verification of Medicare coverage and limits on all Medicare accounts of inpatients.
• Communicates benefit information with the attending physician.
• Determines patient review dates according to established diagnostic criteria.
• Maintains accurate patient insurance information.
• Keeps informed of all new registration procedures.
• Performs quality reviews on all financial files on a daily basis.
• Participates in Discharge Planning Meeting Daily.
• Maintains established departmental policies and procedures, objectives, performance improvement program, safety environmental and infection control standards.
• Notifies supervisor concerning admissions that do not meet the hospital financial policy criteria.
• Analyzes insurance, governmental, and accrediting agency standards to determine criteria concerning admissions, treatment, and length of stay of patients.
• Participates in educational programs and in-service meetings as required.
• Prepares statistical reports.
• Performs all related duties as requested or assigned.
• Keeps informed on the "Baker Act" and Mental Health related laws.
• Strives to communicate effectively and courteously with all groups as delineated by interactions.
• Immediately reports to the supervisor any occurrences or situations that are out of the norm.
• Should participate in Quality Improvement activities as oriented by Supervisor.

Skills

Clear communication

Multitasking

Customer service

Problem solving

Attention to detail

Computer literacy

Education

Associate Degree

Tools

Typewriter

Computer

Job description

Ventura Services Florida is seeking an admissions verifier to verify and monitor patient insurance benefits, authorizations, and entry of information into the computer system. The role includes communicating with physicians, scheduling, and ensuring accuracy of patient data in a fast-paced hospital setting.

The ideal candidate has an Associate Degree, hospital admission or customer relation experience, and preferably bilingual English/Spanish.