Insurance Verifier

United Surgical Partners International; Dallas (TX); On-site; USD 42,000 - 65,000; Full time

Job summary

North Central Surgical Center in Dallas, TX is hiring a full-time Insurance Verifier for the Business Office. You will verify patient insurance benefits, obtain authorizations, and determine patient responsibility prior to procedures, ensuring proper coverage and documentation.

The role requires at least two years of verification/pre-certification experience, knowledge of government plans, and proficiency with Cerner is preferred.

Qualifications

• Minimum two years’ experience in insurance verification & pre-certification for surgeries and preferred knowledge of medical terminology.
• Strong knowledge of Government and State medical plans.
• Strong knowledge of Managed Care Contracts.
• Excellent communication skills; ability to present information effectively to patients, physicians, and other employees.
• Proficiency in computers and relevant software applications.
• Basic math skills.
• Exceptional customer service.

Responsibilities

• Retrieve patient information, verify accuracy (spelling of name, D.O.B., gender, etc.).
• Verify patient insurance benefits using online portals or by contacting carriers directly.
• Obtain authorizations, pre-certifications, requirements, and referrals as needed.
• Ensure high-cost implant, supply, or equipment rental is included on authorization.
• Check insurance company-approved procedure lists and medical policies.
• Calculate patient deductibles and/or copays using contract interpretation of Managed Care Contracts and enter into patient accounting system and spreadsheets.
• Contact patients regarding amounts due prior to 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 verification sheets and upload to patient charts.
• Assist front-end staff in understanding eligibility and patient responsibility verifications.
• Answer incoming department calls and assist patients with benefit inquiries & quotes.
• Perform miscellaneous job-related duties as assigned.

Skills

Insurance verification

Pre-certification

Medical terminology

Government plans

Managed Care Contracts

Communication

Computers/software

Basic math

Customer service

Tools

Cerner

Job description

North Central Surgical Center is a highly successful, Baylor Scott & White affiliated hospital located in Dallas, TX. We partner with the very best team members and medical staff in the area. We are a surgically focused hospital that performs over 12,000 procedures per year.

FACTS ABOUT NORTH CENTRAL: Opened in 2005, 14 Operating Rooms and 30 Medical/Surgical Patient Rooms. 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.

We are currently hiring a full‑time Insurance Verifier for our Business Office Department.

Responsibilities

• Retrieve patient information, verify accuracy (spelling of name, D.O.B., gender, etc.).
• Verify patient insurance benefits using online portals or by contacting carriers directly.
• Obtain authorizations, pre-certifications, requirements, and referrals as needed.
• Ensure high‑cost implant, supply, or equipment rental is included on authorization.
• Check insurance company‑approved procedure lists and medical policies.
• Calculate patient deductibles and/or copays using contract interpretation of Managed Care Contracts and enter into patient accounting system and spreadsheets.
• Contact patients regarding amounts due prior to 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 verification sheets and upload to patient charts.
• Assist front‑end staff in understanding eligibility and patient responsibility verifications.
• Answer incoming department calls and assist patients with benefit inquiries & quotes.
• Perform miscellaneous job‑related duties as assigned.

Required Skills

• Minimum two years’ experience in insurance verification & pre‑certification for surgeries and preferred knowledge of medical terminology.
• Strong knowledge of Government and State medical plans.
• Strong knowledge of Managed Care Contracts.
• Excellent communication skills; ability to present information effectively to patients, physicians, and other employees.
• Proficiency in computers and relevant software applications.
• Basic math skills.
• Exceptional customer service.
• Preferential experience with Cerner.