Insurance Verification & Authorization Specialist

SCA Health (India); Rockwall (TX); On-site; USD 29,000 - 32,000; Full time

Job summary

SCA Health is hiring an Associate Insurance Verification Representative in Rockwall, TX. This role supports verification of patient insurance, determines secondary payer needs, and uses payer websites to gather eligibility and pre-cert information.

You will enter data into the patient accounting system and communicate estimated amounts due to patients. Responsibilities include obtaining authorizations, ensuring correct CPT codes on approvals, and guiding patients through financial policies in

Qualifications

• Requires strong customer service experience.
• Experience with accounts receivable, billing or insurance verification preferred.
• Healthcare industry experience is a must.

Responsibilities

• Verify information for accurate verification and eligibility, may contact physician offices or patients.
• Determine if a secondary insurance should be added to the patient account and select the correct Primary payer.
• Utilize vendor centers or payer websites to obtain eligibility, benefits, and pre-certifications.
• Enter insurance information into the patient accounting system with correct payer and financial class.
• Notify manager of Out-of-Network cases and follow policies for Out-of-Network payers.
• Document findings in the patient account and communicate estimated amounts due prior to service date.
• Call patients as part of CMS-compliance to review ownership, advance directives and patient rights.

Skills

Customer service

Insurance verification

Billing experience

Healthcare experience

Education

High School Diploma or GED

Tools

Patient accounting system

Job description

SCA Health is hiring an Associate Insurance Verification Representative in Rockwall, TX. This role supports verification of patient insurance, determines secondary payer needs, and uses payer websites to gather eligibility and pre-cert information.

You will enter data into the patient accounting system and communicate estimated amounts due to patients. Responsibilities include obtaining authorizations, ensuring correct CPT codes on approvals, and guiding patients through financial policies in