Insurance Verifier

United Surgical Partners International; Dallas (TX); On-site; USD 40,000 - 52,000; Full time

Job summary

North Central Surgical Center in Dallas, a Baylor Scott & White affiliated hospital, is seeking a Full-Time Insurance Verifier in our Business Office Department. The role supports patient access and revenue cycle operations.

Responsibilities include verifying patient information and insurance benefits, obtaining authorizations, calculating patient responsibility, and assisting front end staff. Experience with surgery verification and Cerner is preferred; strong communication and computer skills

Qualifications

• Minimum two years' experience in insurance verification & pre-certification for surgeries and medical terminology preferred.
• Strong knowledge of Government and State Medical plans.
• Strong Knowledge of Managed Care Contracts.
• Proficient in computers and relevant software applications.
• Cerner experience preferred.
• Excellent communication with patients, physicians, and staff.

Responsibilities

• Retrieves and verifies patient information for accuracy.
• Verifies insurance benefits via online resources or carriers.
• Obtains authorizations, pre-certifications, referrals as needed.
• Ensures implants/supplies are included on authorizations.
• Checks approved procedure lists and medical policies.
• Calculates patient deductibles and copays; records in system.
• Contacts patients regarding amounts due before surgery.
• Determines patient responsibility for payment.
• Uploads verifications to patient charts.
• Assists front end staff with eligibility and responsibility questions.
• Answers calls about benefits and quotes.
• Performs miscellaneous duties.

Skills

Communication skills

Basic math

Customer service

Computer skills

Insurance verification

Pre-certification

Tools

Cerner

Job description

North Central Surgical Centeris a highly successful, Baylor Scott & White affiliatedhospital located in Dallas, TX. We partner with the verybest team members and medical staff in the area. We area surgical focused hospital that performs over12,000procedures per year.

FACTS ABOUT NORTH CENTRAL:Opened in 2005, 14 Operating Rooms and 30 Medical/Surgical Patient Rooms. We are conveniently Located at Walnut Hill & 75 in the prestigious NorthPark area Specialties include: Orthopedics, Spine, General Surgery, Pain Management, Urology, GI/Endoscopy, Plastic, and Podiatry surgeries. Managed by United Surgical Partners International & Joint Commission Accredited

Job Description:

North Central Surgical Center is currently seeking a Full-Time Insurance Verifier in our Business Office Department.

• Retrieves patient information, verifying patient information is accurate (spelling of name, D.O.B., gender, etc.).
• Verifies patient insurance benefits by utilizing online websites or by contacting the carriers directly.
• Obtain authorizations from insurance companies/physician offices, pre-certification, requirements and referrals as needed.
• Ensure high cost implant/supply or equipment rental is included on authorization.
• Check insurance company approved procedure lists/medical policies.
• Calculates patient deductibles and/or copays based on contract interpretation of Managed Care Contracts and enter into the patient accounting system and spreadsheets provided.
• Contact patients regarding moneys due prior to date of surgery.
• Determine patient responsibility for payment based on contract and account reviews.
• Determine patient responsibility for cash payment based on reimbursement and account reviews.
• Fill out verifications sheet and upload to patient charts
• Assist front end staff in understanding verification of eligibility and/or patient responsibility.
• Answer incoming department call and assist patients with their benefit inquires & quotes
• Performs miscellaneous job-related duties as assigned.

Required Skills:

Requirements:

• Minimum two years' experience in insurance verification & pre-certification for surgeries and medical terminology preferred.
• Strong knowledge of Government and State Medical plans.
• Strong Knowledge of Managed Care Contract.
• Communication skills: ability to effectively present information to patients, physicians, and other employees of surgery center.
• Proficient in computers and relevant software applications
• Basic math skills
• Provide exceptional customer service
• Cerner experience preferred.