Insurance Verifier-8110

Kingman Regional Medical Center; Kingman (AZ); On-site; USD 25,000 - 33,000; Full time

Job summary

Kingman Regional Medical Center is seeking an Insurance Verifier to support patient access. The role focuses on verifying insurance, obtaining authorizations, and counseling patients on financial responsibilities, ensuring timely processing of admissions and accurate documentation.

The position emphasizes strong customer service, multi-tasking, and compliance with hospital policies, with responsibilities spanning pre- and post-admission activities and collaboration with the billing team.

Qualifications

• Excellent customer service and effective communication.
• Ability to manage multiple priorities and tasks.
• Detail-oriented with strong organizational skills.
• Proficient with computer hardware and software applications.
• Knowledge of medical insurance, managed care and business office basics.

Responsibilities

• Verifies insurance coverage and obtains necessary authorization on observation and inpatient accounts within 24 hours or the next working day.
• Conducts financial counseling and collects patient liability amounts.
• Inputs notes to assist billing and drops insurance flags on accounts.
• Maintains admission reports and performs quality audits on scanned documents.
• Communicates with patients about payment requirements and supports payment arrangements.

Skills

Excellent customer service

Multitasking

Attention to detail

Organizational skills

Computer proficiency

Medical insurance knowledge

Education

High school diploma or equivalent

Tools

DES applications

Job description

Staff Position Description

Position Title: Insurance Verifier Position Code: Verifier-8110

Department: Patient Access Safety Sensitive: YES

Reports to: Admitting Supervisor/Manager Exempt Status: NO

Position Purpose:

All KHI employees are expected to perform their respective tasks and duties in such a way that supports KHI’s vision of providing the region’s best clinical care and patient service through an environment that fosters respect for others and pride in performance.

Key Responsibilities

List of material responsibilities and essentials duties which must be completed in achieving the objectives of the position

• Provides excellent customer service and adheres to the Behavioral Expectations Agreement.
• Verifies insurance coverage and obtains necessary authorization on observation and inpatient accounts within 24 hours or the next working day (to include completing DES applications for self-pay patients.) Obtains extensions as appropriate.
• Conducts financial counseling and collect patient liability amounts.
• Protects the patients and the hospital financial reimbursement by inputting authorization information, verifies the insurance and ensures that all notification/ authorizations are completed according to financial class department policy.
• Conducts duties in order to protect the financial integrity of the hospital.
• Provides guidance and instructions in the interpretation of admitting policies, procedures and practices.
• Inputs notes pertinent to financial information to assist billing department in payment of the claim and drops insurance flags on accounts.
• Contacts responsible party of inpatient accounts either in person or by telephone to advise of insurance coverage rate when insurance does not cover 100%.
• Professionally advises responsible party of payment requirements and follows hospital policy in establishing payment arrangements.
• Completes self-pay assistance applications when appropriate. Preferably prior to discharge.
• Audits all inpatient files to ensure that insurance cards, orders and other admission documents are complete and copied as needed for scanning.
• Ensure admissions documents are scanned and perform Quality Assurance audits on your scanned documents prior to destroying.
• Maintains statistical information and completes month end stats timely (by the 4th day of the following month) and accurately.
• Maintain admission reports daily (billing error report – admissions/discharge summary).
• Consistently demonstrates a willingness to assist co-workers in a courteous manner to support department efficiency.
• Ability to flex into admitting representative tasks at any given notice.
• Performs and communicates in a highly professional manner at all times.
• Consistently demonstrates the ability to assess a situation from a variety of perspectives.
• Considers alternatives and chooses the most appropriate course of action.
• Other duties as assigned.
• Monitors communication with patients regarding their admission, ensures positive outcome, safeguards the public image of the hospital.
• Demonstrates enthusiasm and self-motivation in performing job duties.

Qualifications

Statements regarding minimum educational and experience qualifications, required proficiencies with specialized knowledge, computer proficiencies, military service, required certifications, etc.

• Excellent customer service skills, and the ability to communicate effectively with others.
• Manage multiple priorities and tasks.
• Maintain attention to detail.
• Ability to organize and sort the daily workload while utilizing effective interpersonal skills through both telephone and face to face contact.
• Knowledge of and have the ability to use computer hardware and software applications.
• Knowledge of medical insurance, managed care and basic business office functions.

Education: High school diploma or equivalent

Experience: Minimum of two (2) years in hospital or medical office business setting

Preferences

Preferred attributes for the position which are not absolutely required in the minimum qualifications (i.e., multi-lingual, master’s degree)

Education: Some college education preferred.

Experience:

• Financial counseling experience.
• Insurance billing and medical terminology.

Special Position Requirements

Optional section: any travel, security, risk, hazard or related special conditions which apply to the position

Exposure Categories: Category II: Expected duties have possible, but not routine, potential for exposure to blood, body fluids or tissues

Work Requirements

Optional section: work requirements for physical or other important issues which relate to the job

• Position requires sedentary work, occasionally carrying small objects short distances.
• Must be able to sit at a terminal for up to seven (7) hours daily.
• Must be able to bend, stoop and reach for files and supplies.
• Must be able to get up from chair regularly to get paperwork.

Date Staff Position Description Created / Revised: 03/01/2019