Insurance Verifier

Talentify; Dallas (TX); On-site; USD 42,000 - 54,000; Full time

Job summary

North Central Surgical Center in Dallas, TX is seeking a Full-Time Insurance Verifier in our Business Office Department to support patient eligibility, verify benefits, obtain authorizations, and ensure correct billing for surgeries and implants.

Responsibilities include checking demographic accuracy, contacting insurance carriers, interpreting managed care contracts, calculating deductibles and copays, and notifying patients of amounts due before procedures.

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 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.

Responsibilities

• Retrieves patient information, verifying patient information accuracy (name, D.O.B., gender, etc.).
• Verifies patient insurance benefits by contacting carriers or online websites.
• Obtain authorizations, pre-certifications, referrals as needed.
• Ensure high cost implant/supply or equipment rental is included on authorization.
• Check approved procedure lists/medical policies.
• Calculate patient deductibles and/or copays and enter into billing system.
• Inform patients of amounts due prior to surgery.
• Determine patient responsibility for payment.
• Fill out verifications sheet and upload to charts.
• Assist front end staff with eligibility and patient responsibility.
• Answer calls and assist patients with benefits inquiries & quotes.

Skills

Insurance verification

Pre-certification

Medical terminology

Government plans

Managed care contract

Communication skills

Computer literacy

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 surgical 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. 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.