Insurance Verifier

United Surgical Partners International; Houston (TX); On-site; USD 42,000 - 48,000; Full time

Job summary

United Surgical Partners International is seeking an Insurance Verifier for the Kingwood Endoscopy Surgery Center. The role focuses on obtaining eligibility and benefit information to secure financial clearance for elective and urgent services in a fast-paced ASC setting.

Responsibilities include utilizing Cerner and payer sites, communicating with patients and insurers, and initiating pre-certification and authorization processes. Prior experience with Medicare/Medicaid reimbursement is a plus.

Qualifications

• High School Diploma or GED as minimum education.
• 1–2 years related experience in medical insurance verification.
• Ability to work independently and prioritize responsibilities.
• Knowledge of billing terms and reimbursement concepts helpful.

Responsibilities

• Obtain and record eligibility and benefit information for patients.
• Use Cerner and payer websites and calls to secure financial clearance.
• Communicate with patients, co-workers, physicians, and insurers clearly.
• Initiate admission notification, pre-certification and authorization processes.
• Ensure accounts are financially secure by documenting benefits and patient liabilities.

Skills

Medical insurance verification

Communication skills

Organization

Detail oriented

Independent worker

Deadline driven

Education

High School Diploma or GED

Job description

USPI Kingwood Endoscopy Surgery Center, is seeking a motivatedInsurance Verifier to join our team. Kingwood Endoscopy Surgery Centeris a fast-paced ASC environment committed to producing the highest quality work and experience forpatients and their families.

Job summary: The Insurance Verifier is responsible for obtaining and recording eligibility and benefit information for patients receiving services at Memorial Hermann Surgical Hospital Kingwood. The incumbent will utilize on-line resources such as Cerner and/or payers' websites, as well as the phone, to obtain the necessary information to provide financial clearance and to successfully secure accounts for elective and urgent services timely. The Insurance Verifier will utilize effective communication skills in all interactions with patients, co-workers, insurance companies, physicians, etc. Knowledge of Medicare, Medicaid, and managed care reimbursement methodologies, as well as utilization requirements, will assist in ensuring that criteria for coverage and reimbursement are met. The incumbent will initiate the admission notification/pre-certification/authorization process in a timely manner. Competency requirements for computer entry, as well as insurance procedures, will be maintained.

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Required Skills:

Qualifications:

• High School Graduate or GED
• One or two years related experience in medical insuranceverification.
• Possess the ability to work independently and prioritize responsibilities.
• Sound knowledge of accounting theory and practices to calculate estimated portions due.
• Capability to work with rigid deadlines while maintaining a high degree of accuracy.
• Strong organizational skills and ability to manage multiple projects to ensure documentation standards are followed.
• Communicates openly in a non-judgmental and professional demeanor during all interactions with patients and co-workers.
• Contributes to departmental and hospital patient satisfaction
• Makes physicians and other pertinent parties aware of situations affecting the financial clearance of their patient.
• Serves and the resource person for billing and insurance questions.
• Ensures accounts are financially secure by reviewing and documenting benefits, patient liabilities, authorization/pre-cert requirements and other relevant information.
• Support pre-registration team during peak times.