Insurance Verification & Pre-Certification Specialist

Med Center Health; Bowling Green (KY); On-site; USD 36,000 - 48,000; Full time

Job summary

Med Center Health in Bowling Green, KY, is seeking a role focused on initiating patient intake, verifying insurance, and obtaining authorizations to ensure care is provided with proper coverage and compliance.

The position involves verifying coverage, notifying insurers for pre-certifications, and documenting all information in the Meditech system. Experience in hospital or insurance verification is preferred, and no formal education is required.

Qualifications

• Previous hospital and/or insurance verification or billing experience preferred.
• Education: None required.

Responsibilities

• Verifies insurance and contacts insurance companies via phone and/or online payer portals to notify for pre-certifications for inpatient and observation admissions.
• Verifies and assigns insurance mnemonics and information obtained into Meditech for use by Utilization Review personnel.
• Monitors the status of patient’s insurance coverage and refers information to Financial Counselor as necessary.
• Thoroughly documents information obtained from insurance representatives into Meditech.
• Researches questionable insurance coverage and promptly communicates any identified problems to appropriate personnel for follow up.
• Monitors insurance mnemonics for accuracy, maintains spreadsheet of registration mnemonic issues and communicates with Registration Director for process improvements.
• Establishes and maintains positive working relationships with Utilization Management staff and Physician offices/clinics; contacts physician offices/clinics to resolve issues regarding insurance verification and prior authorization.
• Collaborates with Patient Financial Services, Patient Registration, Utilization Management, and Center Care to ensure Med Center Health is aware of and operates in accordance with insurance front-end requirements.

Job description

Med Center Health in Bowling Green, KY, is seeking a role focused on initiating patient intake, verifying insurance, and obtaining authorizations to ensure care is provided with proper coverage and compliance.

The position involves verifying coverage, notifying insurers for pre-certifications, and documenting all information in the Meditech system. Experience in hospital or insurance verification is preferred, and no formal education is required.