Insurance Verifier

United Surgical Partners International, Inc; Dallas (TX); On-site; USD 36,000 - 48,000; Full time

Job summary

North Central Surgical Center, a Baylor Scott & White affiliated hospital in Dallas, TX, seeks a Full-Time Insurance Verifier to join the Business Office.

You will verify patient information, check insurance benefits, obtain authorizations, calculate patient responsibilities, and support front-end staff with eligibility questions to maintain smooth surgical workflows.

Qualifications

• Minimum two years' experience in insurance verification and pre-certification for surgeries.
• Strong knowledge of government and state medical plans.
• Strong knowledge of managed care contracts.
• Excellent communication with patients, physicians, and staff.
• Proficient with computers and relevant software applications.
• Cerner experience preferred.

Responsibilities

• Retrieves and verifies patient information for accuracy.
• Verifies insurance benefits using online sites or carriers.
• Obtain authorizations and referrals as needed.
• Ensure implants/supplies are included on authorization when applicable.
• Check approved procedure lists and medical policies.
• Calculate patient deductibles and copays; enter into system.
• Contact patients about amounts due before surgery.
• Determine patient financial responsibility; advise cash payments.
• Fill verifications sheet and upload to charts.
• Assist front desk with eligibility verifications and patient inquiries.
• Answer calls and assist patients with benefit questions.
• Perform miscellaneous duties as assigned.

Skills

Insurance verification

Pre-certification

Government plans knowledge

Managed care contracts

Communication skills

Computers/software

Basic math

Customer service

Cerner experience

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.