Insurance Verifier

United Surgical Partners International, Inc; Dallas (TX); On-site; USD 42,000 - 66,000; Full time

Job summary

North Central Surgical Center in Dallas, TX seeks a Full-Time Insurance Verifier to join our Business Office team. You will verify patient information, confirm benefits, obtain authorizations, and calculate patient responsibilities for surgical procedures.

Qualified candidates have at least two years in insurance verification and familiarity with government plans. Proficiency with computers and strong communication skills are essential for patient and staff interactions.

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.
• Excellent communication skills with patients, physicians and staff.
• Proficient in computers and relevant software applications.
• Basic math skills.
• Provide exceptional customer service.
• Cerner experience preferred.

Responsibilities

• Retrieve and verify patient information (name, DOB, gender, etc.).
• Verify insurance benefits via online resources or contacting carriers.
• Obtain authorizations, pre-certifications and referrals as needed.
• Ensure implants/supplies are included on authorization when applicable.
• Check approved procedure lists and medical policies.
• Calculate patient deductibles and co-pays and enter data into accounting systems.
• Contact patients regarding amounts due before surgery date.
• Determine patient responsibility for payment and cash obligations.
• Fill out verification sheets and upload to charts.
• Assist front-end staff with eligibility verification and patient inquiries.
• Handle incoming calls about benefits and quotes.

Skills

Insurance verification

Pre-certification

Communication skills

Customer service

Computer proficiency

Medical terminology

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.